If you haven't heard about it already, there has been a lot of discussion in the media recently about a shortage of Methotrexate (MTX).
At first glance, the main cohort affected by the shortage are children who have Acute Lymphoblastic Leukemia, a type of childhood cancer. The preservative-free version of MTX is injected into spinal fluid in large doses to treat these patients (1).
My original thought was that those of us with RA who take MTX don't take the preservative-free kind. However, it turns out that there is an overall shortage with the injectable version of MTX.
The reason that the shortage occurred is because one of the manufacturers had to completely stop production and close their facility due to concerns about product safety (2). Sounds proactive, right? In this case, not so much.
Because it is leaving many in the lurch, worried that they won't have enough of a drug that is critical to their survival.
One would think that because children are at the forefront of those impacted by the shortage, that there would be a major move to prevent the supply problem. But it's not that simple.
For many of us with RA, MTX has become a mainstay of our treatment, and this shortage could potentially jeopardize our treatment plans, having to find new drugs to accommodate the lack of supply of MTX.
The oral version of MTX, which many cannot tolerate, is not impacted by the shortage.
While pharmaceutical companies work to beef up their supplies of MTX, all we - patients with RA - and parents of children with ALL can do - is hope that this problem is resolved before current supplies are totally depleted.
This is a grim possibility, and a stark reminder of our overtaxed healthcare system.
This crisis is a symptom of a greater problem in our country. At any given time, there are nearly 200 drugs that are at risk of running out.
So while on the surface, it may seem that those with RA would be spared in this fight, which is definitely not the case. Again, all we can really do is watch and wait, and hope for the best.
Here is a list of MTX by brand and how each is being impacted:
And for information on all current drug shortages, more can be found here: