OBR OncologyCancer Drug Shortages: Liability Concerns and Fears for Patient Care

Oncologists and cancer drug shortages are creating a crisis, with patient care at risk and legal liabilities looming.

In the face of critical cancer drug shortages, oncologists grapple with suboptimal patient care and possible legal liabilities. The issue worsens due to insufficient guidelines for alternative treatment options. A contributing factor is the weak financial incentive for drug manufacturers to produce unprofitable generic drugs, compared to branded ones. Consequently, there’s greater dependence on foreign factories, leading to supply chain hitches and quality control issues.

Barbara McAneny, MD, CEO of New Mexico Cancer Center, foresees drug shortages persisting, particularly affecting low-cost treatments. The American Society of Health-System Pharmacists (ASHP) reports shortages of vital oncology drugs like methotrexate, cisplatin, carboplatin, and fluorouracil, crucial for treating various common cancers.

Furthermore, the lack of guidelines on alternative treatments exacerbates oncologists’ concerns about patient outcomes and legal liabilities. This absence of direction leaves physicians making crucial decisions single-handedly.

In response, the American Society of Clinical Oncology (ASCO) has formed an advisory group to develop clinical guidance during these drug shortages. Immediate recommendations include reprioritizing nonessential use of scarce antineoplastic drugs, increasing interval cycles, reducing doses when clinically acceptable, and selecting evidence-based alternatives.

Dr. Jeff Patton, CEO at OneOncology, downplays the fear of legal consequences, stressing that doctors aren’t responsible for these uncontrollable factors. Nevertheless, community physicians may need to consult with other experts and adhere to forthcoming guidelines when unable to secure certain treatments.

The Community Oncology Alliance (COA) is in conversation with officials to confront this problem. Despite projected easing of shortages by the end of 2023, long-term policy changes remain crucial. Nick Ferreyros, COA’s managing director, criticized the faulty drug production system and urged practitioners to demand action from elected leaders.

Despite the ongoing issues, physicians are advised to maintain communication with drug distributors, collaborate locally to obtain drugs, and keep updated with the upcoming academic guidance for alternative options.