By Lisa Rapaport
Most Americans aren’t aware of cancer drug shortages that might lead some patients to receive less effective or more toxic treatments, a U.S. study suggests
In a nationally representative survey of 420 adults, just 16 percent said they knew about shortages of oncology drugs, researchers found.
Even among cancer survivors, just 31 percent were aware of drug shortages.
“For those undergoing cancer treatment, shortage-driven treatment changes have the potential to impact their care,” said lead study author Dr. Zachary Frosch of Dana-Farber Cancer Institute in Boston.
“Yet our findings suggest that, despite the ongoing problem, most people aren’t aware of them,” Frosch said by email.
Oncology drug shortages have become increasingly common in recent years, often involving generic medicines for which there are no alternatives that are similar in safety and effectiveness, researchers note in the journal Cancer.
As a result, drug shortages have caused treatment delays, changes in drug regimens, and missed or suboptimal doses.
The survey, conducted online in 2016, was designed to see how often people were aware of shortages, whether they would want to be told about these situations during their own cancer treatment, and whether they might try to seek care somewhere else when faced with a shortage to avoid treatment with a drug that’s less effective or one that has more serious side effects.
Participants were more likely to be aware of drug shortages when they were white, older, employed, insured, and had more income and education, the study found.
When people did report an awareness of drug shortages, they most often got this information from the news or the Internet, the study found.
Overall, 87 percent of participants said they would want to be told about any therapy substitutions caused by drug shortages when alternative medications had major differences in effectiveness or side effects.
Most people also wanted to know about minor differences
When alternative treatments were much less effective, 72 percent of participants said they would transfer care to another doctor or health system to gain access to the medication in short supply. Less than half of participants would transfer to avoid minor differences effectiveness.
With safety concerns, 61 percent of participants said they would transfer care to avoid major differences in side effects and 40 percent said they would do this even to avoid minor differences in side effects.
People who were black, uninsured, or unemployed were less likely to report that they would transfer care to avoid major differences in safety or effectiveness.
The study wasn’t a controlled experiment designed to prove whether or how awareness of drug shortages might impact patients’ treatment decisions in real life, and it also wasn’t designed to assess any direct impact of shortages on health outcomes for cancer patients.
But many people might not realize how drug shortages impact them until they find themselves undergoing treatment for cancer and unable to get the medicine they need, said Stacie Dusetzina, a researcher at Vanderbilt University School of Medicine in Nashville, Tennessee, who wasn’t involved in the study.
“Drug shortages are a like recall notices for a car – you might not be aware of them unless they directly impact you,” Dusetzina said by email. “It doesn’t surprise me that people are generally unaware of this problem but a lack of awareness obviously doesn’t suggest that people are not interested, particularly if it would impact their care.”
SOURCE: Cancer, online April 9, 2018
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