ASCO 2013: Drug shortage impacts oncologists, patients (VIDEO)
The annual meeting of the American Society for Clinical Oncology (ASCO) offers more than a way to highlight the numerous advances toward a cure for cancer. It also allows for reflection on barriers to quality research and optimal care.
A briefing Friday focused on the impact of declining public funds for cancer research; today, a presentation called attention to the prevailing problem of cancer drug shortages.
For this report, ASCO had randomly selected its members for a survey from March to September 2012. Of the 250 responses received, 214 were used for this study. Among the findings:
- More than 80 percent of oncologists and hematologists reported experiencing drug shortages during that period.
- A total of 94 percent said the shortage had affected treatment, and 83 percent said they were unable to prescribe standard chemotherapy.
- Approximately 13 percent said the shortage lowered patients' enrollment – or caused them to suspend participation – in clinical trials.
According to Food and Drug Administration data, the drug shortage is a rapidly escalating problem. In 2005, there were 61 reported shortages; that figure almost doubled to 121 in 2012.
To adapt to shortages, a significant amount of doctors reported having to switch treatment regimens (78 percent), delay treatment (43 percent), omit doses (20 percent) or refer patients to another practice where the drugs are available (17 percent). One researcher told USA Today that some hospitals have to "hold the equivalent of lotteries to decide which patients get a drug."
All of this means less effective – and more costly – care.
"I fear for some of my patients if this problem goes on for some time, which it will," said Cy Aaron Stein, M.D., Ph.D., the Arthur & Rosalie Kaplan Chair in Medical Oncology at City of Hope. He made his comments in an interview with Everyday Health; he offered additional commentary about the issue in the video above.
Seventy percent of survey respondents also said that their institutions have no formal policy or protocol to help them make treatment adjustment decisions when a shortage occurs.
"Unfortunately, cancer drug shortages will likely be a persistent issue," said Keerthi Gogineni, M.D., co-author of this study. "Doctors are adapting to this new reality as best as they can, but more uniform guidance is needed to ensure that modifications are made in the most educated and ethical way."