NCCN Survey Reveals Best Practices for Managing Cancer Drug Shortage

In a recent survey conducted by the National Comprehensive Cancer Network (NCCN), 89% of the responding oncology centers still reported shortages of various anti-cancer agents and supportive care medications. Not only do these shortages burden patients, caregivers, and providers, but they could delay clinical trials and slow the progress of new therapies.¹

Survey revealed 89% of the responding centers still reported shortages of various anti-cancer agents and supportive care medications.

The survey followed data published one year ago and then 6 months ago, finding that 93% of cancer centers surveyed experienced shortages of the crucial chemotherapy carboplatin at its peak. In June 2023, 70% of the centers surveyed also lacked adequate supply for cisplatin.

While these percentages have dipped to only 11% for carboplatin and 7% for cisplatin, centers continue to face challenges when it comes to clinical trials, treatment delays, and the need for strategies to address the impact of shortages.

“Critical drug shortages were not a new problem last year and they continue to be a problem now,” Crystal S. Denlinger, MD, chief executive officer, NCCN, explained in a statement.¹ “The dual carboplatin and cisplatin shortage was particularly severe, and we were able to help sound the alarm during its peak. Despite a renewed attention to drug shortages over the past year, 89% of the responding centers in the latest survey are still reporting shortages of various important anti-cancer agents and supportive care medications.”

The survey analyzed data collected from May 28 through June 11, 2024, on how the drug shortage has impacted practices and provides recommendations for policy solutions to address these challenges.

Out of a total of 28 responding centers, 14% reported shortages of a single drug, 29% for 2 drugs, and 18% for 3 drugs.² Additionally, 57% reported a shortage of vinblastine, 46% for etoposide, and 43% for topotecan. Shortages were also found for many other treatments, including dacarbazine, 5-fluorouracil, and methotrexate.

When asked if all patients were able to receive the intended dose and schedule of drugs in short supply at a center, 56% said yes with mitigation strategies enacted, and 37% said yes without mitigation strategies enacted.²

For those who responded yes, mitigation strategies included waste management (80%), limited use of current stock (53%), use of range minimum for recommended dose (33%), and use of range maximum for recommended dose (33%).

Moreover, the ongoing shortages were found to have impacted clinical trials at 43% of centers, reduction in enrollment (58%), increased administrative burden (83%), and budgeting. Furthermore, 27% of centers reported treatment delays due to shortage-related challenges that required additional prior authorization.

Remarking on how the current marketplace incentivizes unsustainable practices, 75% of respondents stated they would like to see economic incentives put in place to encourage high-quality manufacturing of medications, especially for generic versions of drugs that are often in short supply. Additionally, 64% of respondents said they felt that there was a need for a broader buffer stock payment and that they would like to see more information on user experience for various suppliers.

“The current situation underscores the need for sustainable, long-term solutions that ensure a stable supply of high-quality cancer medications,” Alyssa Schatz, MSW, senior director of Policy & Advocacy, NCCN, said in a statement.¹ “The federal government has a key role to play in addressing this issue. Establishing economic incentives, such as tax breaks or manufacturing grants for generic drugmakers, will help support a robust and resilient supply chain—ultimately safeguarding care for people with cancer across the country.”

References

1. New survey from NCCN finds cancer drug shortage management remains a moving target, impacting clinical trials. NCCN. News release. June 26, 2024. Accessed June 25, 2024.

2. NCCN Best Practices Committee Drug Shortage May 2024 Update Survey Results. June 26, 2024. Accessed June 25, 2024.