Drug Shortages Are Common, But Public Knowledge About Them Is Not

While drug shortages are a pressing problem in the world of oncology, only a small percentage of patients are actually aware of the issue, according to a recent study published in the journal Cancer.

The researchers gave a 13-item cross-sectional survey to 420 people, ranging in age, gender, socioeconomic status and health history. Overall, only about 16 percent reported being aware of drug shortages. But when looking at the individuals with a personal cancer history, that number nearly doubled to 31 percent.

“One reason people may not be aware could be because they have not personally encountered a cancer drug shortage (or any drug shortage) before. Perhaps unsurprisingly, people in our study who themselves had a history of cancer were more likely to have heard of cancer drug shortages,” study author Zachary Frosch, M.D., professor of medicine at Harvard Medical School, said in an interview with CURE.

“This may be because they personally encountered a shortage or because, given their cancer diagnosis, they were more likely to pay attention to the press coverage or other discussions surrounding shortages.”

The cause of drug shortages is complex and multi-factorial, and beyond the scope of the study, Frosch said. But if patients and their loved ones want to see if a certain drug is facing a shortage, they can visit the list hosted on the Food and Drug Administration’s (FDA) website.

But just because a patient sees their drug on the list, that does not mean that they should immediately panic.

“Just because those drugs are in national shortage, it doesn’t inform patients whether any of those drugs are in shortage at their institution,” Frosch said. “On this list are both chemotherapeutic drugs, and also key supportive medications used in cancer care.”

But when it comes to patients facing drug shortages in their institutions, most survey respondents (87 percent) said that they would want more information on the shortage, as well as an effective substitution. Also, 83 percent of patients reported that they would want more information regarding the differences in side effects if they were on a drug that was facing a shortage.

Nearly two-thirds (72 percent) said that they would transfer care to avoid a substitution, however, that amount fell to 61 percent if the substitution care had significantly different side effects.

But not all of the people surveyed said that they would go to a different facility to avoid switching drugs. In fact, black, uninsured, unemployed, lower income and less educated respondents were found to be less likely to transfer care.

Transferring care is not always an easy task for patients, as they typically have ongoing relationships with their providers and feel more comfortable in the treatment center that they attend. Similarly, common disparities among these patient populations may also play a factor.

“It may be that these same challenges mentioned above are even more daunting for traditionally disadvantaged populations who already experience barriers in their health care, and this makes them less able to transfer care in such a situation,” Frosch said. “Perhaps recognizing these challenges, when responding to our hypothetical vignettes, fewer people reported that they would transfer their care to avoid a shortage than would want to know about the shortage.”

Moving forward, Frosch emphasized that patient-provider communication is key when it comes to potential drug shortages.

“If being treated for cancer, people can speak with their physician about how a shortage might be affecting them and how best to manage the situation,” he said. “Treatment decisions should be individualized and are best discussed with each patient’s own physician.”