Cancer drug shortages: Awareness and perspectives from a representative sample of the US population

Frosch, Zachary A K; Cronin, Angel M.; Gagne, Joshua J.; Teschke, Maxwell P.; Gray, Stacy W.; Abel, Gregory A.

doi:10.1002/cncr.31246

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…We should inform families that these shortages place their children’s lives at greater risk. To raise awareness and evoke public pressure to address the systemic factors underlying shortages, cancer centers should publicly post current data about the shortages . As we have previously articulated, patients and families affected by drug shortages must be proactively engaged and appropriately apprised of decisions about their treatments.…”

Section: Call To Armsmentioning

confidence: 99%

“…Although severe drug shortages have been prevalent for well over a decade, the US population is largely unaware of the issue. According to a national study published in May 2018, 16% of US adults report being aware of US cancer drug shortages . Among health care professionals, knowledge and awareness of drug shortages may also differ; in a study of physicians and pharmacists treating childhood cancer, pharmacists were twice as likely to report such a shortage as physicians .…”

Section: Introductionmentioning

confidence: 99%

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Chemotherapy and Supportive Care Agents as Essential Medicines for Children With Cancer

et al. 2019

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Section: Call To Armsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chemotherapy and Supportive Care Agents as Essential Medicines for Children With Cancer

et al. 2019

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“…Finally, patients may be largely unaware that shortages occur 47 . This unfamiliarity may make shared decision making difficult and limit public support for policies intended to reduce shortages.…”

Section: Future Directionsmentioning

confidence: 99%

The Drug Shortage Era: A Scoping Review of the Literature 2001–2019

Tucker

Cao

Fox

et al. 2020

Clin Pharma and Therapeutics

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Drug shortages continue at crisis levels in the United States, with no end in sight. Extensive research in disparate areas has been conducted to explore the impact that shortages have on patients and the healthcare system. We conducted a scoping review to categorize existing work in order to identify opportunities for further research. We considered peer‐reviewed and non‐peer‐reviewed articles involving non‐vaccine, human drug shortages in the United States published in English between January 2001 and May 2019. In total, 430 papers were charted according to the following categories: causes, impacts on care, health outcomes, costs, management, prevention, and federal government response. Of these, 112 papers considered causes; 199 discussed effects, 158 considered management strategies, and 140 discussed prevention. We provide a resource to navigate the vast literature on drug shortages in the United States, identifying areas in need of further research. This review highlights the widespread negative effects that drug shortages have on patients, providers, and health system costs in the United States. Evidence of their ramifications should be sufficient to justify policy change. Future work should move from characterizing the problem to working toward solutions to reduce the impact, occurrence, and effects of shortages.

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“…Treatment delays, changes in regimens, and missed or suboptimal doses of chemotherapy have been previously reported. 5 As drug shortages are becoming exceedingly more frequent this calls for increased awareness to the potential for errors in the medication use process, including medication administration that can be significant and potentially life-threatening or fatal.…”

Section: Figurementioning

confidence: 99%

Intrathecal Methotrexate Containing the Preservative Benzyl Alcohol Erroneously Administered in Pediatric Leukemia Patients: Clinical Course and Preventive Process

Messinger¹,

Maxa²,

Hennen³

et al. 2020

The Journal of Pediatric Pharmacology and Therapeutics

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Administration of intrathecal chemotherapy for leukemia is a common procedure in pediatric oncology. The direct delivery of drug into the cerebral spinal fluid requires that no preservative be used. Preserved drugs administered in error can result in significant neurotoxicity. A case series is described where preservative-containing methotrexate was incidentally administered intrathecally. All patients were treated at Children's Hospitals and Clinics of Minnesota. Medical records of the patients affected were reviewed and abstracted for this report. Four children with acute lymphoblastic leukemia received 1 dose of intrathecal methotrexate that contained 0.07% benzyl alcohol in January 2019. Overall, minimal to no symptoms were seen after dosing. The error was traced to a drug shortage in which benzyl alcohol–containing methotrexate was obtained and incorrectly stocked. A novel replacement drug procurement process was developed within our institution. The process includes sequestered queues where a drug awaits evaluation and independent double check of entry accuracy in the electronic health record and pharmacy parenteral dose preparation software prior to release and use. In contrast to IV administration, intrathecal benzyl alcohol at concentrations ≥ 0.9% can cause significant neurotoxicity. Although minimal, if any, neurotoxicity was seen in patients who received a 10-fold lower concentration of benzyl alcohol than previously associated with complications, all institutions should recognize the potential for this error and implement similar safety precautions to ensure that this type of error will not occur.

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Cancer drug shortages: Awareness and perspectives from a representative sample of the US population

Cited by 7 publications

References 28 publications

Chemotherapy and Supportive Care Agents as Essential Medicines for Children With Cancer

Chemotherapy and Supportive Care Agents as Essential Medicines for Children With Cancer

The Drug Shortage Era: A Scoping Review of the Literature 2001–2019

Intrathecal Methotrexate Containing the Preservative Benzyl Alcohol Erroneously Administered in Pediatric Leukemia Patients: Clinical Course and Preventive Process

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