Rx Shortages Hitting Cancer Patients Hard

Cancer medication supply shortages are affecting patient care and medical research

(RxWiki News) The conversation about medication shortages has died down recently. The problem hasn’t gone away, though. Cancer patients are apparently feeling the brunt of ongoing supply problems.

Shortages in cancer medications continue to impact patient care and medical research. 

Not having access to key medicines has resulted in treatment changes and delays. In turn, these changes have affected patient response, outcomes and medical bills. 

"Ask which chemotherapy agents you’re receiving."

Medication shortages have been of growing concern in the US since 2007. According to the US Food and Drug Administration, quality issues with manufacturers are the biggest reason behind the supply problems. Manufacturing production delays and discontinuations are also involved.

A nationwide survey was conducted to measure the impact of these shortages. The study’s lead author was James Hoffman, PharmD, an associate member of the St. Jude Department of Pharmaceutical Sciences and the hospital's medication outcomes and safety officer.

A total of 243 healthcare professionals responded to survey sent to 1,672 members of the Hematology/Oncology Pharmacy Association and other organizations in September 2011.

Respondents included oncology pharmacists and others involved in managing cancer medications in local hospitals, academic medical centers and cancer treatment facilities around the US.

Here’s what the survey uncovered:

  • 98 percent of participants said they had seen shortages of at least one cancer medication during the last 12 months.
  • 93 percent said shortages caused treatment delays, including chemotherapy and other drug therapies.
  • 16 percent reported negative patient outcomes including complications related to the treatment and worsening of the cancer.
  • 34 percent of institutions involved in the survey reported 20 hours a week of staff time was spent trying to compensate for the supply issues.
  • The most commonly affected medications were fluorouracil (Arucil), leucovorin, liposomal doxorubicin (Caelyx, Myocet) and paclitaxel (Taxol).
  • Respondents indicated that the scarcities were affecting ovarian, breast and colorectal cancers the hardest.

In 2011, a total of 267 medications were in short or spotty supply. In February of 2013, the University of Utah Drug Information Service was tracking national and regional shortages of more than 320 medicines.

Supply issues persist despite efforts by the FDA. In 2012, the agency adopted new tools to prevent or ease the shortages, including having manufacturers report pending supply interruptions.

“This survey documents the risk that drug shortages pose to cancer patients of all ages," Dr. Hoffman said in a news release.

"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. Drug supplies remain unpredictable and serious problems persist."

The results appear in the April 1 edition of the American Journal of Health-System Pharmacy. Dr. Hoffman’s contributions to the research were supported by the American Lebanese Syrian Associated Charities and the National Institutes of Health. The authors have declared no potential conflicts of interest.

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Review Date: 
March 20, 2013