Many doctors report trouble getting cancer drugs

More than eight in 10 U.S. cancer specialists have struggled to find the drugs they need to best treat their patients, a new survey has found.

Such drug shortages could affect people with colon cancer, breast cancer and leukemia. They include chemotherapy drugs prescribed after a tumor has spread.

"These are drugs used for common and curable cancers," Dr. Keerthi Gogineni of the Hospital of the University of Pennsylvania in Philadelphia told Reuters Health.

"It is becoming increasingly difficult for patients with cancer to receive the lifesaving treatments they need," she and her colleagues write in a letter published in the New England Journal of Medicine. The shortages "compromise the delivery of standard cancer care and lead to higher costs."

Their work builds on an earlier survey, released in March, of pharmacists and other health professionals who buy cancer drugs for hospitals. In that study, 16 percent said shortages had caused problems for patients, including more disease progression or additional treatment-related complications.

A co-author of that survey, James M. Hoffman, said the new study "adds additional evidence for the harmful consequences of chemotherapy drug shortages on cancer patients."

Hoffman is the medication outcomes and safety officer at St. Jude Children's Research Hospital in Memphis, Tennessee.

"It demonstrates that chemotherapy shortages frequently force chemotherapy regimens to be changed or delayed, which may lead to increased costs or even worse outcomes," he told Reuters Health in an email.

One report published a year ago found fewer patients survived Hodgkin lymphoma - a type of immune system cancer - when doctors had to switch from using the standard chemotherapy drug to a substitute.

Such shortages have happened in the U.S. since 2006 but have been becoming more common. In October, the U.S. Food and Drug Administration (FDA) issued a strategic plan designed to prevent shortages and proposed requiring drug companies to promptly notify it if a supply problem looms. But the FDA cannot compel action to prevent a shortage.

"In the last five years, there's been a three-fold increase in the number of shortages reported," Gogineni said.

Sometimes shortages happen because a company didn't make enough of a given drug. Or the company could be trying to get more people to use a more profitable drug instead of a less profitable one.

To gauge the current problem, Gogineni's team sent surveys to 454 cancer doctors in late 2012 and early 2013; 250 responded.

The vast majority - about 83 percent - said they couldn't prescribe the preferred drug at least once in the last six months.

More than three-quarters of them said the shortages forced major changes in treatment. That included switching to different drug combinations, delaying treatment or skipping doses.