New research published this week by the American Journal of Health-System Pharmacy (AJHP
) reveals that shortages of oncology drugs continue to have a widespread and significant impact on patient care.
The article, “Impact of Shortages of Injectable Oncology Drugs on Patient Care
,” by Jennifer Goldsack, M.Chem., M.A.(Oxon), M.S.; Cynthia Reilly, B.S.Pharm.; et al; is published online ahead of print at www.ajhp.org
. The research was conducted by the Value Institute at Christiana Care Health System, the University of Pennsylvania, Fox Chase Cancer Center, and the American Society of Health-System Pharmacists (ASHP).
The survey of 358 pharmacy directors at health systems throughout the U.S. who are members of ASHP asked participants about the extent to which their facilities were affected by oncology drug shortages, strategies for responding to shortages, and the effects of shortages on costs, patient safety, and outcomes.
Key findings include:
Ninety-eight percent of respondents reported at least one drug shortage during the previous 12 months.
Seventy percent of respondents reported instances of inadequate supplies of drugs needed to treat patients during the previous 12 months.
Sixty-three percent of respondents reported that their facility had completely run out of at least one injectable oncology drug during the previous 12 months.
Sixty-two percent of respondents reported using alternative drug regimens due to shortages, such as changing the combination of drugs used to treat a specific cancer drug or using a different combination of drugs.
Respondents also reported making the following treatment changes due to shortages:
Changing the drug dose (46%)
Treatment delays (43%)
Referring patients to other facilities (21%)
Twenty-four percent of respondents reported safety events (e.g., incorrect substitute medication or dosage, adverse reaction, or disease progression) resulting from oncology drug shortages.
Respondents reported using a variety of strategies to manage oncology drug shortages (e.g., increasing inventory, increasing staff time devoted to managing shortages, implementing strategies to minimize product waste, and identifying substitution protocols ) that led to cost increases.
The study authors suggest that while there are limitations in the evidence base, there is a “pressing need to introduce practice guidelines for allocation decisions to support clinicians involved in the care of cancer patients.” The authors also recommend that allocation decisions include the input of pharmacists, who should have the support of their institutions’ ethics committees when making these choices.