A Vizient white paper released today demonstrates how the lack of information about medication access across the supply chain is exacerbating the shortage of seven oncology drugs used to treat a multitude of cancers. In survey results included in the paper, more than 94% of respondents reported an impact on pharmacy operations and patient care due to carboplatin and cisplatin shortages. View “Evaluating the impact of the oncology drug shortage.”
Six antineoplastic oncology medications are in short supply in the United States due to the December shutdown of a manufacturing plant in India — capecitabine, carboplatin, cisplatin, docetaxel, fluorouracil and methotrexate; a seventh, fludarabine, has been in short supply since 2019. The total number of units of the seven drugs sold to Vizient Pharmacy Program participants, which includes 60% of the nation’s acute care hospitals, increased 12% January through May 2023 compared to the same time during the previous year, according to Vizient data. At the same time, the Vizient Clinical Data Base showed relatively flat growth (1.5%) during that time for patient volumes that would receive antineoplastics as part of their oncology medications.
“Providers are naturally concerned about delivering the appropriate treatment to their patients. During a disruption providers have no awareness of production by alternate manufacturers or re-openings of facilities,” said Carina Dolan, associate vice president, clinical oncology, pharmacoeconomics and market insights. “The lack of transparency and trust in information coming from manufacturers and distributors leads to over-ordering, which can leave some hospitals without the necessary medications needed to deliver care.”
Starting in December, aggregated demand for the seven drugs spiked over 136% compared with historical purchase patterns and remained elevated at the time of this press release. Despite implementing various procurement strategies to ensure patient care needs are being met, the proportion of Vizient Pharmacy Program participants receiving less than 50% of their historical order quantities reached 57% as of May 2023.
“The fulfillment data we reviewed highlights challenges with how product availability and demand fluctuate considerably when a shortage occurs. As an industry, we must look at every link in the supply chain and determine how we can work collectively to improve transparency and the flow of information to quickly and more evenly implement product access and mitigation strategies that help ensure equitable distribution of medications when disruptions occur,” said Dolan.
Survey results: Provider and patient impact
In April, Vizient conducted a survey of its pharmacy program participants with 32 unique oncology network provider customers responding. Respondents reporting an impact from the shortage ranged from 72% to 97%, depending on the drug, with 56% of respondents implementing some type of mitigation strategy for cisplatin, used for a variety of cancers. The most common substitute was carboplatin, also impacted by the disruption.
Providers reported several procurement strategies to mitigate the shortage, including buying from alternative sources or sourcing alternative presentations and vial sizes and shifting inventory across the health system; conservation strategies, including restricting administration of certain indications and omitting a drug from regimens when possible; patient prioritization strategies, including delayed treatment; and overall increased communications during the shortage.
Vizient, Inc. is headquartered in Irving, Texas