Drug Shortages Continue to Compromise Cancer Care

The media spotlight is not on drug shortages like it was a year or two ago, but oncologists are still struggling to find the right medications for their patients, and patients are paying for the ongoing drug shortage – in both the care they receive and the cost of treatment.

Between September of 2012 and March of 2013, researchers Keerthi Gogineni, MD, of the Hospital of the University of Pennsylvania and Katherine Shuman, BS, and Ezekiel J. Emanual, MD, PhD, of the University of Pennsylvania randomly selected 454 U.S. oncologists and surveyed them on the frequency and type of chemotherapy shortages they encountered. A total of 250 responded, although analysis was limited to those 214 oncologists who “routinely prescribed cancer drugs.”

Drug shortages mean major changes in treatment plans

The results were startling: 82.7 percent of the respondents said that during the prior six months they had been unable to prescribe the preferred chemotherapy drug to a patient at least once due to drug shortages. Over three-quarters of the respondents said that drug shortages had prompted major changes in the treatment plans they set out for their patients, changes that might have included a change in the drug regimen or substitution of drugs mid-way through treatment.

Furthermore, one-third of the respondents said that drug shortages forced them to delay treatment for some patients while having to make decisions about excluding others from treatment altogether. Almost 70 percent of these doctors also found that, although drug shortages were prevalent, their practices or their cancer centers provided no formal guidance regarding allocation of drugs.

Finally, over half of those who ran into drug shortages said they had to substitute an expensive brand-name drug in place of a much cheaper generic drug. In some of these cases, this substitution could have resulted in cancer care costs 100 times what the patient would have had if the generic were available.

The authors concluded that because generic drug shortages appear to be here for the foreseeable future, formal guidance on how to address them ought to be issued to doctors.

Source: NEJM