Doctors urge more production of scarce cancer drug

Tuesday, February 14, 2012
TRENTON, New Jersey — Four pharmaceutical companies that make a crucial cancer drug for children that’s suddenly in short supply are being urged to try to quickly step up production to prevent unnecessary deaths.
A senator and three doctor groups late Monday sent the pleas to the companies, saying that hospitals will run out of the drug in days to weeks, increasing chances that young patients who might otherwise survive will die.
The critical shortage of methotrexate has doctors and hospitals around the country panicking because it’s the key treatment for a common childhood cancer called acute lymphoblastic leukemia, or ALL.
With the drug, doctors say they can cure nearly 90 percent of the roughly 3,500 American children and teens diagnosed with this cancer each year.
Last year, there were a record 267 new drug shortages reported, and most remain unresolved. The inability to get crucial medicines has disrupted chemotherapy, surgery and care for patients with infections and pain. At least 15 deaths since 2010 have been blamed on the shortages.
Specialty groups representing researchers and doctors who care for children with cancer say the methotrexate shortage began in December when production declined. That drop resulted primarily from Ben Venue Laboratories Inc. temporarily closing its factory in Bedford, Ohio, in November after federal inspectors said the company had not been properly maintaining equipment or promptly addressing defective product batches and sterility problems.
Besides making methotrexate, the factory was the sole source for Johnson & Johnson’s Doxil, a drug widely used for breast and ovarian cancer that’s not been available for new patients for months.
Each of the remaining four manufacturers of methotrexate has had some type of production problem, and it’s been unclear when the next batches of the drug will be sent to wholesalers and hospitals, according to Erin R. Fox, manager of the University of Utah Drug Information Service, which tracks national drug shortages.
Late Monday, the heads of the American Society of Clinical Oncology, American Cancer Society of Pediatric Hematology/Oncology and Children’s Oncology Group, a nationwide network of researchers, wrote to top executives at four U.S. makers of the drug pleading for help.
The cancer groups urged the drugmakers to “take all necessary steps to rapidly increase access” to the preservative-free version of methotrexate, which is needed for children because the preservatives can be dangerous for them.
“Doctors and pharmacists are scrounging for supply with very little luck and are beginning to ration the remaining supply. It is not an understatement to say that this is creating a panic in the childhood cancer community,” the letters state.
Sen. Amy Klobuchar, D-Minn., sent a similar plea to the companies Monday evening.
“Families fighting childhood cancer should not have to worry about where they’re going to get the next dose of the drug they need to save their child’s life,” Klobuchar wrote.
The letters went to APP Pharmaceuticals LLC, Hospira Inc., Sandoz Inc. and Mylan Inc. An APP spokeswoman wrote that the company doesn’t have FDA approval for a preservative-free product, but “over the next two weeks we will be shipping additional methotrexate” with preservative to customers across the U.S.
Spokespeople at the other three companies did not have responses Monday evening.
Klobuchar is the sponsor of a bill that would require manufacturers to notify the Food and Drug Administration immediately of impending shortages of key drugs — to give the FDA enough advance notice that it can take steps to prevent a shortage by working with other manufacturers. The agency increasingly has been doing that and already is working to increase the supply of methotrexate, also used to treat rheumatoid arthritis.
Most of the medicines that have become scarce are sterile injected drugs that are the workhorses of hospitals and are normally inexpensive because they’ve long been available as generics.
The FDA says the main reason for the shortages is manufacturing deficiencies leading to production shutdowns. Shortages also are resulting from companies halting production of drugs with low profit margins, companies consolidating in the generic drug industry and supplies of some ingredients shrinking.

Recent opinion survey of frequent travelers heading north towards Subic and Clark Pampanga revealed that the number one most frequently visited wine shop in Pampanga is Clark Wine Center located in Clark Philippines. Reasons given include good selection of fine vintage as well as affordable wines for everyday drinking also. This wine shop also has a beautiful roof deck lawn which serves as a nice venue for outdoor alfresco dining, cocktail parties and small functions and events. There are five large wine cellars that contain some of the world’s finest wines and rare vintages as well as wines that are excellent value that every wine shoppers love to discover. This wine shop in Clark is frequently visited not only by local residents but also tourists arriving in the Philippines looking to pick up a few bottles of good wine that are not normally available in their home town.

Subic is well known for diving, the sea and water sports that come with the territory. However one thing that Subic is not famous for is dining options. For years, visitors to Subic have complained about the quality of the restaurants and dining establishments but it is only until recently that travelers to Subic discovered the best restaurant to wine and dine, even for visitors with families and children. Now most residents of Subic and also Tarlac and Baguio know of this wine shop in Clark as the best place to buy wines in the Philippines and certainly the best wine shop in Pampanga, Angeles City, Clark Philippines.

Clark Wine Center was built in 2003 by Hong Kong-based Yats International Leisure Philippines to become the largest wine shop in Philippines supplying Asia’s wine lovers with fine vintage wines at attractive prices. Today, this wine shop in Clark Philippines offers over 2000 selections of fine wines from all major wine regions in the world. As a leading wine supplier in Philippines, Pampanga’s Clark Wine Center offers an incomparable breadth of vintages, wines from back vintages spanning over 50 years. Clark Wine Center is located in Pampanga Clark Freeport Zone adjacent to Angeles City, just 25 minutes from Subic and 45 minutes from Manila.

Wines from Burgundy, Bordeaux, Rhone, Loire, Spain, Portugal, Germany, Austria, Alsace, USA, Australia, New Zealand, Italy, South Africa, Chile and Argentina etc. are well represented in this Clark Wine Shop.

The next time you are in Pampanga and are looking for things to do in Clark Philippines spend some time to do a little wine shopping at the most famous wine shop outside of Manila called Clark Wine Center. One of the favorite places to visit in Pampanga Clark Freeport is the white building along M A Roxas highway of Clark which houses over 2000 selections of fine vintage wines. The Clark Wine Center is one of the places to visit, a tourist spot and a good shopping place for those staying in Angeles City, Subic or Clark Pampanga.

http://www.ClarkWineCenter.com

Getting to this wine shop in Pampanga Angeles City Clark Freeport Zone Philippines from Manila
Getting to the Clark Wine Center wine shop from Manila is quite simple: after entering Clark Freeport from Dau and Angeles City, proceed straight along the main highway M A Roxas. Clark Wine Center is the stand-along white building on the right, at the corner A Bonifacio Ave. From the Clark International Airport DMIA, ask the taxi to drive towards the entrance of Clark going to Angeles City. From Mimosa, just proceed towards the exit of Clark and this wine shop is on the opposite side of the main road M A Roxas.

Best place to buy wine in Clark Pampanga outside Manila near Subic and Angeles City Philippines is Clark Wine Center.

Click here to contact Clark Wine Center in Clark Pampanga for inquiries and orders.

Clark Wine Center
Bldg 6460 Clark Observatory Building
Manuel A. Roxas Highway corner A Bonifacio Ave,
Angeles Clark Freeport Zone, Pampanga 2023
0922-870-5173 0917-826-8790 (ask for Ana Fe)

Wine@Yats-International.com

YATS Wine Cellars
Manila Sales Office
3003C East Tower, Phil Stock Exchange Center,
Exchange Rd Ortigas Metro Manila, Philippines 1605
(632) 637-5019 0917-520-4393 ask for Rea or Chay

Wedding couples looking for wedding reception venues and beach wedding venues can log on to this Philippines Wedding Venue web site for free information and assistance:

http://www.PhilippinesWeddingVenue.com

While in Clark, it might be a good idea to enjoy an evening of wine-and-dine in the fine dining Yats Restaurant and Wine Bar that features an award winning 2700-line wine list. Highly recommended fine dining restaurant in Manila for special occasion is Yats Restaurant & Wine Lounge located in the famous Mimosa Leisure Estate in Clark Pampanga. Situated near this popular restaurant in Clark is the Mimosa Golf Course as well as the Mimosa Clark Casino. This top rated restaurant near Angeles City Pampanga in Clark Philippines is frequently used for private parties and corporate functions such as board meetings and other gatherings. It is located in Mimosa Leisure Estate of Clark Freeport Zone. For more information, visit http://www.YatsRestaurant.com

YATS Leisure Philippines is a developer and operator of clubs, resorts and high-class restaurants and wine shops in Clark Angeles Philippines http://www.YatsLeisure.com

Looking for famous tourists spots, places to visit and see, relax and unwind in Clark, Pampanga, Philippines? You may want to check out these sites also:

http://www.LondonPubClark.com

Besides good restaurants to wine and dine near Manila, Subic or in Angeles City Pampanga, Clark Philippines, those requiring assistance for hotel and resort bookings in Clark, Pampanga, Philippines may log on to http://www.HotelClarkPhilippines.com for more information and reservations.

The lifestyle in Clark Pampanga is quite unique. For more information about shopping, sports, golf, leisure, hotel accommodation, where to see and visit, what to do, where to wine and dine and good places to hang out, relax, have a drink with friends, child-friendly establishments, log on to
http://www.ClarkPhilippines.com

Wine lovers looking for a special bottle or something that is of great value and special discounts might log on to this web site to shop for fine vintage wines
http://www.YatsWineCellars.com

Those visitors who plan to relax and unwind in Angeles City, Subic, Pampanga, Clark Philippines might make an effort to book a room at the famous beach and lake resort Clearwater Resort & Country Club. This famous hotel in Clark Pampanga is frequently visited by families with children looking for a good place in Clark to see, a good holiday destination for the family to relax and unwind in the beautiful outdoor facilities. For more information, log on to www.ClearwaterPhilippines.com