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Cancer Drug Shortages Mean Higher Costs and Greater Risk

Experts warn that shortages persist (Mar. 21)

A national survey of health professionals conducted by the Hematology/Oncology Pharmacy Association has shown that drug shortages are taking a heavy toll on cancer patients, forcing treatment changes and delays that for some patients meant worse outcomes, more therapy-related complications, and higher costs.

The survey queried oncology pharmacists and others involved in managing cancer drug shortages for academic medical centers, community hospitals, and other cancer treatment facilities nationwide. Of the 243 individuals who completed the survey, 98% reported having dealt with a shortage of at least one chemotherapy agent or other essential cancer-related drug in the previous 12 months. Ninety-three percent of respondents reported that shortages forced delays in chemotherapy administration or other changes in cancer drug therapy.

The researchers found that the shortages also disrupted cancer research and added to the cost and risks associated with cancer treatment. One institution linked a patient’s death to a shortage-related medication mistake. Overall, 16% of respondents tied shortages to adverse patient outcomes, including disease progression or more treatment-related complications.

The survey — the first to focus on the effects of cancer-related drug shortages — covered a 12-month period ending in October 2011. The results will be published in the April 1 edition of the American Journal of Health-System Pharmacy.

“This survey documents the risk that drug shortages pose to cancer patients of all ages,” said senior author James Hoffman, PharmD. “To cure cancer patients, we must often use complex treatment regimens, and shortages add unnecessary complexity. Unlike medications for other diseases, there are few, if any, therapeutically equivalent alternatives available for many oncology drugs in short supply.”

About one-third of institutions in the survey reported that pharmacy staff spent at least 20 hours each week working on issues related to drug shortages. That included time spent trying to find scarce medications to purchase or identifying alternatives. Eighty-five percent of respondents reported shortages led to higher medical costs.

Drug shortages also disrupted clinical trials of new cancer treatments. The survey found that shortages forced 44% of institutions to either halt or delay enrollment in clinical studies. The problem also led some providers to change or omit medications.

In the survey, the drugs most frequently reported as being in short supply were fluorouracil, leucovorin, liposomal doxorubicin, and paclitaxel. Such shortages particularly affected patients with ovarian, breast, and colorectal cancers.

Source: St. Jude Children’s Research Hospital; March 21, 2013.

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