Shortages of Chemo Medication Common

Cancer medication shortages for chemotherapy common in survey of oncologists

(RxWiki News) When diagnosed with cancer, medication shortages probably aren't patients' first concern. But this issue can have a big impact on patients, and might be a common problem.

A new article highlighted the issue of cancer medication shortages by surveying oncologists who administer these medications.

The study found that around 80 percent of the surveyed oncologists had experienced a chemotherapy medication shortage in the previous six months.

"Don't hesitate to approach your pharmacist with prescription questions."

According to the authors of this study, who were led by Keerthi Gogineni, MD, of the Hospital of the University of Pennsylvania in Philadelphia, "It is becoming increasingly difficult for patients with cancer to receive the lifesaving treatments they need."

Dr. Gogineni and colleagues explained that common generic chemotherapy medications for a variety of cancers have been prone to shortages for the last several years. The study aimed to measure the experience of oncologists with cancer medication shortages.

These researchers completed a survey from September 2012 to March 2013. The participants were randomly selected US oncologists. The doctors were asked about the types of chemotherapy medications they had experienced shortages of, how often shortages occurred and how shortages impacted treatment.

Over 400 oncologists were contacted, 250 of whom responded. Of these, 214 oncologists reported routinely prescribing cancer medications, so the analysis focused on these respondents.

Of these 214 doctors, 82.7 percent reported being unable to prescribe the chemotherapy medication they would have preferred at least once in the past six months, due to shortages of the medication.

"The drugs associated with the most commonly reported shortages — leucovorin (reported by 66.4 percent of the oncologists surveyed), liposomal doxorubicin (reported by 61.7 percent), fluorouracil (reported by 18.7 percent), bleomycin (reported by 17.3 percent), and cytarabine (reported by 16.4 percent) — are integral to curing malignant conditions such as colon cancer, breast cancer, and leukemia as well as providing palliation for patients with metastatic cancer," Dr. Gogineni and colleagues wrote.

Over 75 percent of the 214 oncologists reported that shortages had led to major changes in the method of treatment. These changes included alterations in what was prescribed or the substitution of medications midway through treatment.

The researchers also noted that although issues with shortages seemed to be common, 69.9 percent of the doctors reported that their practices or cancer centers had no formal guidance for a decision-making process in the face of these issues.

When faced with shortages, 59.2 percent of the doctors reported they had substituted a more expensive brand-name medication for an unavailable generic medication. Dr. Gogineni and and colleges noted that one such substitution for treating colon cancer — swapping the brand-name Xeloda (capecitabine) for generic fluorouracil — could make one round of treatment 140 times more expensive.

"The majority of oncologists face chemotherapy shortages that compromise the delivery of standard cancer care and lead to higher costs," the study's authors wrote. The researchers suggested that formal guidance on addressing these issues be developed in the short-term to help lessen any negative impact on cancer patients.

This study was published December 19 in the New England Journal of Medicine. No conflicts of interest were reported.

Review Date: 
December 24, 2013