Cancer drug shortages are eroding the quality and increasing the costs of cancer care, according to the first national survey to focus specifically on the impact of these shortages. The survey involved 243 oncology pharmacists and others involved with managing cancer drug shortages for academic medical centers, community hospitals, and other cancer treatment centers. Of those surveyed, 98% reported having dealt with a cancer drug shortage within the past year, and 93% said that shortages caused delays in chemotherapy or other changes in drug therapy.
The shortages also caused disruptions in cancer research and increased the risks and costs associated with treatment. Furthermore, approximately 16% of respondents linked shortages to problems in patient outcomes, including disease progression or treatment-related complications. Shortages also delayed clinical trials at 44% of the institutions surveyed.
The survey, which focused on a 12-month period ending in October 2011, was conducted by the Hematology/Oncology Pharmacy Association, a national professional organization of oncology pharmacists and others in the field. Senior author James Hoffman, PharmD, an associate member of the department of pharmaceutical sciences at St. Jude Children's Research Hospital in Memphis, Tennessee, says that shortages add unnecessary complexity to treating cancer and that, unlike medications for other diseases, few therapeutically equivalent options exist for many of the oncology drugs that are currently in short supply.
In February, the University of Utah Drug Information Service tracked regional and national shortages of more than 320 drugs, which is the highest number since 2010, says Dr. Hoffman. In the survey, the drugs most frequently reported as being in short supply were 5-fluorouracil, leucovorin, liposomal doxorubicin, and paclitaxel. The shortages hit especially hard for patients with ovarian, breast, and colorectal cancers.
A previous study led by researchers at St. Jude found that a shortage of the chemotherapy drug mechlorethamine increased the risk of disease recurrence in young patients with Hodgkin lymphoma. The recurrences forced patients to undergo additional intensive therapy, which increased the risk of infertility and other future health problems.