Cancer patients in the us are suffering from drug shortages

Cancer patients in the us are suffering from drug shortages

Eighty-three percent of cancer doctors have documented that they have experienced oncology drug shortages. Most of them also say their patients' treatments have been affected, according to a study presented at the 2013 American Society of Clinical Oncology.

The findings revealed that shortages - which have significantly affected medications to treat pediatric, blood, and gastrointestinal cancers - have left doctors surveyed without the supplies to treat patients with standard chemotherapies for a range of cancers.

The current study was the largest of its kind to survey chemotherapy shortages, with a random sample of 500 board-certified oncologists in the US in late 2012 and early 2013. The goal was to analyze the impact of drug shortages on their practices during the last six months.

The study's senior author Keerthi Gogineni, MD, MSHP, an instructor in the division of Hematology-Oncology in Penn's Abramson Cancer Center, said:

"Our results indicate that the vast majority of oncologists in the country are facing wrenching decisions about how to allocate lifesaving drugs when there aren't enough to go around. The potential impact of these drug shortages is vast: they're putting patients at risk and driving up costs of cancer care."

Additionally, the authors pinpointed several ways in which oncologists have modified their practices when recommended drugs are scarce:

  • 78% report treating patients with a different drug or drug regimen
  • 77% substituted different drugs halfway through therapy
  • 43% had to postpone their patients' treatment
  • 37% had to pick certain patients who needed a specific drug
  • 29% eliminated doses and 20% decreased doses
  • 17% referred patients to another practice
The authors suggest that the widespread treatment delays demonstrate the urgency of this problem. Risks arise when doctors substitute drugs partway through the patients' treatment schedule, because often there is no established dosage equivalence or known safety profile when the drug is used with other therapies.

Clinical trials can also be affected when drugs needed for them are scarce. Researchers found that 12% of the time, drug shortages prevented enrollment in these trials, postponed administration of a study drug, or suspended involvement of patients in human studies.

The results also detail the expensive burden caused by drug shortages. The prices of drugs and their substitutes have increased in recent years. Additionally, generic drugs have become harder to obtain.

Despite the incidence of the shortage problems, 70% of doctors said their cancer centers had no formal recommendations or guidelines for making assignment decisions. The lack of drug supplies force doctors to make difficult decisions and weigh the needs of different but equally vulnerable patients against one another.

Gogineni concluded:

"This is a dynamic problem, and when we learn about new shortages on the horizon, there is usually not a lot of time to plan for how to deal with them. Guidelines must be rapidly updated and disseminated, both to large academic medical centers and smaller community hospitals and practices -- where the majority of cancer care is delivered and which often lack the bulk-buying power to keep scarce drugs in necessary supply."

A small-scale survey on the same topic was conducted earlier this year by St. Jude Children's Hospital and had similar results, suggesting that drug shortages weaken the quality of and increase the cost of cancer care.

Drug Shortages Impacting Cancer Patients in the US (Video Medical And Professional 2020).

Section Issues On Medicine: Disease