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TOPLINE:

More than half of practices within the National Cancer Institute Community Oncology Research Program (NCORP) faced drug shortages in recent years that disrupted patient care and created operational challenges.

METHODOLOGY:

• Oncology drugs are regularly in short supply in the US. However, there is limited evidence on how often and in what ways drug shortages affect cancer care delivery in community practices.
• To investigate, researchers analyzed baseline survey data from 96 NCORP community oncology practices that were enrolled in an ongoing cancer care study between December 2020 and July 2024.
• Practices completed an 18-item drug shortage survey and a 14-item pharmacy baseline survey. Practices were asked on a scale — never encountered (score of 1) to always encountered (score of 5) — whether their sites experienced a range of practice-level cancer care delivery problems, with scores of 4 or 5 considered to be a yes.
• Researchers assessed the proportion of practices seriously affected by drug shortages over the past 3 months (defined as a disruption in cancer care delivery), as well as strategies used to address the drug shortages.

TAKEAWAY:

• Of 93 practices with complete data, 52.7% were seriously affected by drug shortages spanning 23 oncology drugs — most commonly carboplatin (46.9%), leucovorin (42.9%), and cisplatin (36.7%).
• Practices that were seriously affected were more likely than those not seriously affected to report a lack of suitable treatment alternatives (34.7% vs 13.6%), switching to equally effective (36.7% vs 15.9%) or less effective treatments (14.3% vs 2.3%), or spending substantial resources to manage drug shortages (70.8% vs 50.0%).
• About half of practices (n = 47) said they faced ethical dilemmas, such as having to prioritize drug allocations. And roughly 12% of all practices said they were unable to enroll patients in clinical trials due to drug shortages.
• All practices had strategies in place to mitigate the effects of drug shortages, with three quarters or more using alternative drugs, stockpiling, developing action plans, purchasing off-contract or through secondary markets, or holding pharmacy clinical team meetings. Seriously affected practices were more likely than those not seriously affected to switch to alternative administration routes and less likely to increase staff time or hire staff to manage shortages.

IN PRACTICE:

“The current oncology drug shortage is increasingly affecting [cancer care delivery] in NCORP practices, potentially affecting clinical decision-making process, patient outcomes, and quality of life, as well as clinical trial enrollment,” the authors of the study wrote, adding that “a thorough policy approach is necessary to address both the immediate impacts and the underlying causes of drug shortages.”

SOURCE:

The study, led by Lauren V. Ghazal, PhD, University of Rochester School of Nursing in Rochester, New York, was published online in JCO Oncology Practice.

LIMITATIONS:

The cross-sectional design precluded assessing whether challenges due to shortages worsened over time. Relying on self-reported data from NCORP study staff may have introduced recall bias. Participation in cancer care delivery studies wasn’t uniformly optional for all NCOPRP practices, potentially limiting generalizability.

DISCLOSURES:

The study was supported by a University of Rochester Cancer Center NCORP Research Base grant and NCORP Community Affiliate grants. One author declared serving as a member of the JCO Oncology Practice Editorial Board. Another author reported receiving travel and accommodation expenses and having other ties with various sources. Detailed disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.