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Published on: December 9, 2015
Impact of Drug Shortages on Cancer Care Delivery Within the National Cancer Institute Community Oncology Research
Lauren V Ghazal1, Supriya Mohile2, Kah Poh Loh3
1University of Rochester School of Nursing, Rochester, NY.
Purpose:
Drug shortages represent a challenge in oncology care, with potential repercussions including suboptimal treatment options, treatment delays, and medication errors. However, there is scant evidence on how drug shortages interrupt cancer care delivery (CCD) nationally and specifically across National Cancer Institute (NCI) Community Oncology Research Program (NCORP) community oncology practices.
Methods:
Between December 2020 and July 2024, 96 NCORP community oncology practices were enrolled. NCORP practice study staff completed the Drug Shortage Baseline Survey and Pharmacy Baseline Survey. The primary outcome was proportion of practices seriously affected by drug shortages (ie, encountered CCD problems [change to less effective treatments, adoption of more toxic alternatives, treatment delays, or an increase in medication errors or near misses]) in the past 3 months. Secondary outcomes included CCD problems among practices (eg, ethical dilemmas) and strategies used by practices (eg, use of alternative drugs, stockpiling). Finally, we described differences between seriously affected and nonaffected practices.
Results:
Nearly 54% of NCORP practices were seriously affected by drug shortages in the past 3 months, with 23 drugs (including carboplatin [24.7%], leucovorin [22.6%], and cisplatin [19.4%]). Seriously affected practices were more likely to report lack of suitable alternatives (34.7% v 13.6%), substantial resources spent (70.8% v 50.0%), and change to alternative administration (73.5% v 52.3%) and were less likely to hire staff to address shortages (16.3% v 36.4%). Strategies to address shortages included using alternative drugs (91.5%), stockpiling (87.2%), and developing action plans (84.0%). Most (50.5%) practices reported experiencing an ethical dilemma related to a drug shortage.
Conclusion:
Drug shortages influenced CCD among NCORP practices. This study underscores the need for robust strategies and policies to mitigate these effects and enhance the resilience of oncology practices.
Insights
Drug shortages significantly impacted cancer care delivery in over half of National Cancer Institute Community Oncology Research Program practices. Strategies like alternative drugs and stockpiling were common, but ethical dilemmas arose.
Area of Science:
- Oncology
- Healthcare Management
- Pharmaceutical Policy
Background:
- Drug shortages pose a significant threat to oncology care delivery.
- Impacts include suboptimal treatments, delays, and medication errors.
- Limited data exists on national drug shortage effects on cancer care delivery (CCD) within community oncology practices.
Purpose of the Study:
- To assess the national impact of drug shortages on CCD.
- To specifically evaluate effects across National Cancer Institute (NCI) Community Oncology Research Program (NCORP) practices.
- To identify challenges and coping strategies employed by these practices.
Main Methods:
- A survey-based study involving 96 NCORP community oncology practices from December 2020 to July 2024.
- Utilized the Drug Shortage Baseline Survey and Pharmacy Baseline Survey.
- Primary outcome: proportion of practices seriously affected by drug shortages impacting CCD.
Main Results:
- Nearly 54% of NCORP practices were seriously affected by drug shortages.
- Commonly affected drugs included carboplatin, leucovorin, and cisplatin.
- Seriously affected practices reported more issues with alternatives, resource strain, and administration changes, while less likely to hire staff.
Conclusions:
- Drug shortages substantially influenced cancer care delivery within NCORP practices.
- Practices employed strategies like alternative drug use and stockpiling.
- There is a critical need for enhanced strategies and policies to mitigate drug shortage impacts and bolster practice resilience.
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