Cancer drug shortages: Awareness and perspectives from a representative sample of the US population

Cancer. 2018 May 15;124(10):2205-2211. doi: 10.1002/cncr.31246. Epub 2018 Apr 8.

Abstract

Background: Although cancer drug shortages are a persistent problem in oncology, little is known about the awareness and perspectives of the US population with respect to shortages.

Methods: In 2016, we administered a 13-item cross-sectional survey to 420 respondents who were randomly selected from an online, probability-based sample demographically representative of the adult US population with respect to sex, age, race/ethnicity, education, geography, and income. Analyses applied poststratification sampling weights to draw national inferences.

Results: Overall, 16% of respondents reported being aware of drug shortages. Those with a personal history of cancer were more likely to be aware (31% vs 14% [P = .03]). In the overall cohort, most reported wanting to be informed about a substitution due to shortage: 87% and 82% for major or minor differences in efficacy, and 87% and 83% for major or minor differences in side effects. Most also reported they would transfer care to avoid a substitution: 72% for major differences in efficacy, and 61% for major differences in side effects. Black respondents, the uninsured, the unemployed, those with lower income, and the less well-educated were all less likely to report that they would transfer care to avoid major differences in efficacy (all P < .05).

Conclusion: These data suggest that the US population is largely unaware of cancer drug shortages. Moreover, if being treated for cancer, most people would want to know about drug substitutions, even if it were to result in only minor differences in efficacy or side effects. With more significant differences, many would transfer care. Cancer 2018;124:2205-11. © 2018 American Cancer Society.

Keywords: antineoplastic drugs; cancer; chemotherapy; drug shortages; medical oncology.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / supply & distribution*
  • Cross-Sectional Studies
  • Drug Substitution*
  • Drugs, Generic / administration & dosage
  • Drugs, Generic / adverse effects
  • Drugs, Generic / supply & distribution*
  • Female
  • Health Care Rationing
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Patient Preference / statistics & numerical data
  • Treatment Outcome
  • United States
  • Young Adult

Substances

  • Antineoplastic Agents
  • Drugs, Generic