DES MOINES, Iowa — The parents of Kinsley Delzell woke up Friday morning worried that the chemotherapy drug that their 3-year-old daughter needed next week would not be there at Blank Children’s Hospital. Since November, Kinsley has received treatment for Acute lymphoblastic leukemia.
A nationwide shortage of drugs like methotrexate wiped out supplies at the hospital. But by lunch time, the Delzells got the welcome news from Kinsley’s doctor.
“Our pharmacy team has been creative,” explained Dr. Wendy Woods-Swafford, the medical director at Blank Children’s Cancer and Blood Disorders Center.
Dr. Woods said that Kinsley is one of hundreds of Blank’s patients battling leukemia and sarcoma who rely on methotrexate for treatment. But thanks to a combination of efforts, Blank’s staff has secured the needed medicine for the next few weeks.
One method was a process called batching where staff used instruments to essentially collect almost every drop from a vial to maximize supply.
“By batching them we are able to use entire supplies from each vial and we are able to get more kids in with the current supply that we have. So with some of the changes that they’ve made and the work that they’ve done with allocating drugs and acquiring drugs from every nook and cranny that they can find, we are in good shape for the next few weeks.”
The challenge is that once a vial is opened, its contents are only able to be used for a number of days or numbers of hours (depending on the type of medicine). So staff has already rearranged treatment schedules for families to bunch them up around each other.
“It’s not convenient for families to move around their chemotherapy days. It’s even hard sometimes on the nursing floor where those number of admissions would be spread out over a 5 to 7 day period. They’re now batching into two days. But it’s the right thing to do and enables us to be able to meet more of the demand.”
Dr. Woods also said that a slowly increasing supply of available of drugs, plus assistance from nearby Mercy Medical Center, helped Blank to meet demand for now. Although, that’s based on the existing number of patients. So that supply could strain with new patients beginning treatment.
“The stress on us and the stress on our system and living literally email to email about where we are with our supply and what we’re going to do over the next few weeks … I can’t fathom the stress that there is on the parent knowing that this is the studied, tried and true, to give us the survival rates that we talked about at the time of diagnosis,” she said. ‘And we may not be able to get the standard of care. Not only that, there’s not a substitute for it.”
Dr. Woods said she has received reports that the supplies of drugs like methotrexate could increase in a few months as drug companies increase output.