As many as 98.9% of physicians recently reported cancer drug shortages, according to the Community Oncology Alliance (COA). The surveyed physicians said that, because of drug shortages, the cancer progressed faster in more than 60% of patients and more than 70% of patients had more severe side effects.
Almost half saw more than one patient per day affected by a drug shortage and 58% say the shortage in cancer care drugs is increasing. Over 80% of the patients and over 90% of the practices affected by a cancer drug shortage also experienced a more severe financial burden.
The root cause of the drug shortage is economic, said Ted Okon, executive director of COA. Medicare’s system for reimbursing cancer drugs has created pricing instability. That has resulted in disincentives for manufactures to produce these low-cost but vital generic cancer drugs and invest in manufacturing facilities for these products.
In addition to issues of optimal treatment, drug substitutions made because of a shortage often result in patients facing significantly higher costs. When treating ovarian cancer, a commonly used drug is Leucovorin. The cost to Medicare is $35 per dose; the patient co-payment is $9. But Leucovrin is a generic drug and in short supply, says Dr. Patrick Cobb, an oncologist at the Frontier Cancer Centers and Blood Institute, Billings, Montana, and COA past president. The substitute is a branded drug that is readily available. The cost to Medicare for a dose of the branded drug is $2,000 and the cost to the patient is $520. “This is an unacceptable consequence of the drug shortage crisis,” he said. The complete survey results and comments from respondents are available at http://www.communityoncology.org/site/coa-studies.htm.
