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.
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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: http://bit.ly/2qjptri Cancer, online April 9, 2018.
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