i am charlie penley from tennessee. us spend the majority of my time taking care of patients solomon comfortable in this environment. i talk about the impact of drug shortage on my patients. i speak on behalf of clinical oncology. 30,000 members and their patients thank you for holding this hearing. drug shortages reached crisis proportions and i hope this will frame potential solutions. large and small community based and hospital based practices are having challenges treating the patients. the situation is worsening. drug shortages have tripled since 2005/2006. almost all cancer types are affected. leukemia, breast cancer and colon cancer. shortages are forcing us to change the way we treat our patients. often a drug in short supply is potentially curative. there is no reasonable substitute. are practice treats many patients with non hodgkin's leukemia a life-threatening but curable disease. cytarabine is a central component of treatment but that agent has been and remains intermittently in short supply. physicians ha