Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Aug 10, 2017; 8(4): 336-342
Published online Aug 10, 2017. doi: 10.5306/wjco.v8.i4.336
Physician approaches to drug shortages: Results of a national survey of pediatric hematologist/oncologists
Jill C Beck, Baojiang Chen, Bruce G Gordon
Jill C Beck, Baojiang Chen, Bruce G Gordon, Department of Pediatric Hematology/Oncology, University of Nebraska Medical Center, Omaha, NE 68198-2168, United States
Author contributions: Beck JC designed the study and gathered data; Chen B provided statistical analysis of results; Beck JC and Gordon BG wrote the manuscript.
Institutional review board statement: The Institutional Review Board at University of Nebraska Medical Center (UNMC) in Omaha, Nebraska reviewed and approved the study.
Conflict-of-interest statement: None.
Data sharing statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jill C Beck, MD, Department of Pediatric Hematology/Oncology, University of Nebraska Medical Center, 982168 Nebraska Medical Center, Omaha, NE 68198-2168, United States. jill.beck@unmc.edu
Telephone: +1-402-5597257 Fax: +1-402-5596782
Received: October 31, 2016
Peer-review started: November 4, 2016
First decision: April 27, 2017
Revised: May 4, 2017
Accepted: July 14, 2017
Article in press: July 17, 2017
Published online: August 10, 2017
Processing time: 280 Days and 2.5 Hours
Abstract
AIM

To evaluate personnel involved in scarce drug prioritization and distribution and the criteria used to inform drug distribution during times of shortage among pediatric hematologists/oncologists.

METHODS

Using the American Society of Pediatric Hematology/Oncology (ASPHO) membership list, a 20 question survey of pediatric hematologists/oncologists was conducted via email to evaluate personnel involved in scarce drug prioritization and distribution and criteria used to inform scarce drug distribution.

RESULTS

Nearly 65% of the 191 study respondents had patients directly affected by drug shortages. Most physicians find out about shortages from the pharmacist (n = 179, 98%) or other doctors (n = 75, 41%). One third of respondents do not know if there is a program or policy for handling drug shortages at their institution. The pharmacist was the most commonly cited decision maker for shortage drug distribution (n = 128, 70%), followed by physicians (n = 109, 60%). One fourth of respondents did not know who makes decisions about shortage drug distribution at their institution. The highest priority criterion among respondents was use of the shortage drug for curative, rather than palliative intent and lowest priority criterion was order of arrival or first-come first-served.

CONCLUSION

Despite pediatric hematology/oncology physicians and patients being heavily impacted by drug shortages, institutional processes for handling shortages are lacking. There is significant disparity between how decisions for distribution of shortage drugs are currently made and how study respondents felt those decisions should be made. An institution-based, and more importantly, a societal approach to drug shortages is necessary to reconcile these disparities.

Keywords: Pediatric hematology/oncology; Chemotherapy; Ethics

Core tip: The frequency of drug shortages are increasing and heavily impact physicians and patients. However, processes for handling drug shortages are lacking. An institution-based, and more importantly, a societal approach to drug shortages are necessary to reconcile these disparities.