- This topic has 1 reply, 2 voices, and was last updated 5 years, 7 months ago by
.
-
Posts
-
Posted on behalf of Joe
In the July support group meeting in Vancouver, for the first time we had a participant who was impacted by BCG shortage. The doctor had informed the patient that due to BCG outage, the BCG treatment would be delayed till September. I have seen a post of BCC forum that a patient’s BCG treatment stopped after three inductions due to the shortage. So, it is definitely happening in Canada, but not clear about the extent of the impact.
I have been following how BCG Shortage is being dealt with in south of our border. Below is the summary of what I know so far.
1. It is happening in sub full scale.
2. BCAN’s recommendation to doctors and patients in handling the current situation is almost the same as what BCC has announced.
It is noted that it states that ” it is subject to as always, to physician judgment in individual cases”. This makes sense but at the same time I see different hospitals or doctors approach differently to deal with the shortage and it can give some confusion to patients.
3. Actual cases
1. The university hospital in Rochester, New York – They give full dose treatment for 6 weeks, but do not give maintenance treatment because
studies had shown less than full dose has less efficacy, so their medical oncologist said. In the same hospital he had seen two cases
that the patients had to remove their bladder because of the shortage of BCG, which the patients would have gone BCG treatment to attempt
preserve the bladder if there was no shortage.
2. MD Anderson cancer center in Texas approach is to give 1/3 of full dose for the initial 6 weeks course and subsequent maintenance course because
studies show lower dose give as good efficacy as full dose, so a well known Dr. Ashish Kamat says. Incidentally, the committee of cancer of French Urology
Association published their study and the study had shown that 1/3 of full dose treatment had shown no substantial difference as full dose.
3. In some hospital where they are doing Phase III clinical trials of Tokyo-172 strain BCG are recommending to the clinical trial to its patients. The Tokyo-172
clinical trial is being done at 143 sites all in USA, NOT in Canada for about 1,000 patients according to the information from US Clinical Trial website.
** I do not know the reason Canada has chosen to try to get Russian BCG than joining US to get Tokyo-172 and starts clinical trials in Canada. Are we going to use with or without clinical trials? I know BCC is talking to Health Canada, but details are not mentioned.
4. In US, some patients go to different hospital, even different states to get BCG treatment.
** I do not know if this is feasible in Canada. Maybe, in the same health care authority in the same province?
4. Other matters
It is easily said than done recommending 1/3 dose option. Logistically, it requires to schedule multiple patients to be treated on the same day. It may be possible for large hospitals where they have many bladder cancer patients, staff and a facility to split the full dose vial into 1/3. In the States, there is a problem for claiming to the insurance company / medicare system as they need a new claim code for 1/3 dose. I do not know how it can be handled in our healthcare/insurance system. We may think it is easier for MERCK to ship 1/3 dose as a vial, but some expert says it may create more shortage risk in changing their production line to produce 1/3 dose vial.
On July 9, Sen. Chuck Schumer was calling on the federal government and drug manufacturer Merck to address what he called a “critical shortage” of a bladder cancer drug. I love to see our politicians to get involved in this matter become a champion of those bladder cancer patients who are facing difficult situation because of the shortage of BCG. Should we politicize the issue? Is that it takes to fix the problem.
Joe
I’m not sure about the politicizing but think that some way of getting stories on the local media may help draw attention to the importance of BCG plus raise the awareness of bladder cancer at the same time.
I would question getting BCG from Russia – Is there a way to test samples before purchase to make sure that their BCG is the same/similar strength and content to the one that has been used here in Canada?
What is the Tokyo 172 strain? Why do we need clinical trials? Is this a new version that needs trials?
- You must be logged in to reply to this topic.
