Ongoing shortages of common oncology chemotherapies have compelled physicians to substitute more expensive drugs, delay or suspend clinical trials, or even skip doses of chemotherapy, according to survey results gathered by a team from the University of Pennsylvania.
Ongoing shortages of common oncology chemotherapies have compelled physicians to substitute more expensive drugs, delay or suspend clinical trials, or even skip doses of chemotherapy, according to survey results gathered by a team from the University of Pennsylvania.
The survey, led by Zeke Emanuel and Katie Shuman, represented a joint effort by Penn’s Perelman School of Medicine and the Wharton School of Business to reach 455 board-certified US oncologists selected from the membership of the American Society of Clinical Oncologists (ASCO), to assess drug shortages and how they affect decision-making.
Results of the survey, taken between September 20, 2012, and January 20, 2013, were released today at the 49th Annual Meeting of ASCO in Chicago.
The Penn survey, which was self-administered, received 245 responses, for a rate of 55%. Of these, 210 respondents were practicing medical oncologists or hematologists.
Respondents reported overwhelmingly that drug shortages had affected their practice within the previous six months. Ninety-two percent (163) of the oncologists reported that patient treatment was affected and that 83% (174) were unable to prescribe standard chemotherapy.
Yet physicians were just as likely to have received little or no guidance on what to do when confronted with drug shortages; 70% (146) of oncologists said their cancer centers or practices lacked formal policies for how to allocate scarce drugs.
The 5 agents most likely to be in short supply were: leucovorin (68%), liposomal doxorubicin (63%), 5-FU (19%), bleomycin (18%), and cytarabine (17%).
At times, physicians substituted more expensive, branded drugs for those unavailable. This was reported 38% of the time. Shortages prevented enrollment of a patient in a clinical trial or delayed administration of a study drug 13% of the time.
Results of oncologists responding to the Penn survey reporting modifications due to drug shortages were as follows (n = 173): switch regimens, 79%; substitute drug during therapy, 77%; delay treatment, 43%; choose among patients, 37%; omit doses, 29%; reduce doses, 20%; refer patients to another practice, 17%.
________________________________________
Emanuel Z, Shuman K, Chinn D, Gogineni K. Impact of onocology drug shortages. J Clin Oncol. 2013;(suppl; abstr CRA6510).
CMS' 340B Repayment Proposal May Harm Vulnerable Hospitals, Reward Those With Higher Revenues
April 26th 2024The 340B hospitals not receiving an offsetting lump-sum payment from CMS following 2018-2022 cuts later ruled unlawful are disproportionately rural, publicly owned, and nonacademic, according to a new study.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen