Arthritis Patients Are Being Denied Methotrexate Post-Dobbs. Are People With Cancer Next?

Arthritis Patients Are Being Denied Methotrexate Post-Dobbs. Are People With Cancer Next?

https://www.forbes.com/sites/victoriaforster/2022/07/18/arthritis-patients-are-being-denied-methotrexate-post-roe-are-people-with-cancer-next/

After the U.S. Supreme court overruled Roe v Wade last month, ripples have been felt throughout U.S. healthcare, with doctors claiming that the new restrictions threaten lives.

As part of this, in States where abortion is banned or now more severely restricted, multiple people with arthritis and other rheumatoid conditions have reported that they can no longer get their prescriptions filled, forcing them to try to find other medications to help manage their conditions.

Most of the people reporting they have been denied refills of their medication are women and there are suggestions that this is violating federal anti-sex discrimination laws. On the 14th of July, the Department for Health and Human Services said it was investigating the reports and communicating with pharmacies to remind them of their duties.

“We are committed to ensuring that everyone can access health care, free of discrimination. This includes access to prescription medications for reproductive health and other types of care,” said Xavier Becerra, Health and Human Services Secretary said on the 14th in a statement.

Methotrexate can be used to terminate pregnancies and is the most common drug used to treat ectopic pregnancy, where the fetus develops outside of the womb and is non-viable, as well as life-threatening for the pregnant individual. But methotrexate can also be used in therapy for certain types of cancer, working by reducing the amount of a nutrient called folate a cell can use, preventing it from growing and replicating itself.

“Methotrexate is an essential drug for oncologists,” said Julie R. Gralow, MD, FACP, FASCO, Chief Medical Officer of the American Society of Clinical Oncology (ASCO). “It is an essential chemotherapy agent for the treatment of multiple cancers including both adult and pediatric acute lymphoblastic leukemia and osteosarcoma,” Gralow added.

Methotrexate is also used to treat certain types of lymphoma, cancers which have spread from elsewhere to form tumors on the meninges-thin layers of tissue which cover the brain and occasionally breast and head and neck cancers. But so far, at least, prescribing issues affecting patients with arthritis do not appear to be affecting patients with cancer who need treatment with methotrexate.

“We have certainly heard concerns about this possibility, but we have not yet heard of a case where a patient with cancer has been denied methotrexate. We are communicating regularly with our members so that we have the most current information about the realities of delivering cancer care,” said Gralow.

However, it is not only methotrexate which may get caught up with the new anti-abortion laws in several states. Many cancer treatments are not compatible with pregnancy and on difficult occasions where a pregnant individual is diagnosed with cancer, one choice is to elect to have an abortion to allow treatment to proceed.

“ASCO’s singular focus is assuring every individual with cancer is able to receive high quality, equitable, evidence-based cancer care. For pregnant patients with cancer, the option to terminate a pregnancy is an important component of high-quality cancer care. We will continue to do everything within our means to ensure patients have access to equitable, evidence-based cancer care,” said Gralow.

The Supreme Court decision is still very recent and many of the ripple effects of the ruling have yet to be felt. Gralow says that ASCO is regularly reaching out to their volunteers and state societies to better understand what is happening on the ground in states where abortion is now banned or strictly limited.

“Patients must be able to trust their doctors. We are concerned that the Dobbs ruling creates uncertainty and confusion that can undermine this trust and the doctor-patient relationship, threatening patient access to potentially lifesaving, life-extending, or palliative treatment,” said Gralow.

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