Shortages of pediatric cancer medicines threaten outcomes

Shortages of essential chemotherapy drugs for children undergoing cancer treatment has been an increasingly frequent obstacle for patients and hospitals across the country. In a new position paper in JAMA Pediatrics, Baylor College of Medicine’s Drs. Stacey Berg and Brooke Bernhardt address this issue and call for the development of an essential medicines list for this group of patients to help ensure reliable access and forecast future shortages.

“We have been dealing with shortages of essential and critical medications in the United States for many years. In this paper, we take a bold step of proposing a list of medications which we consider to be essential to the treatment of children with cancer in our setting,” said Bernhardt, assistant professor of pediatrics – hematology/oncology at Baylor and Texas Children’s Hospital.

Shortages of essential medicines for childhood cancers can result in increased medication errors, delayed administration of life-saving therapy, inferior outcomes and patient deaths.

“All children, including those undergoing treatment for cancer, have a fundamental right to healthcare, and these drug shortages compromise that right,” said Berg, professor of pediatrics – hematology and oncology at Baylor and Texas Children’s Hospital. “Essential medicines lists are used in other countries, but one has yet to be established for the United States, which could help alleviate this economic and healthcare burden domestically.”

In addition to compiling a list of essential drugs, the authors also provide recommendations on what to do when there are shortages, as well as how to forecast need in the future.

“We need a more active planning process,” said Berg, who also is associate dean for research assurances and member of the Dan L Duncan Comprehensive Cancer Center at Baylor. “These medicines should be considered critical infrastructure in healthcare, and this approach has implications beyond pediatric oncology; children with other serious diseases should have access to evidence-based medicines that are deemed essential to preserve life and function.”

Many of these agents are relatively inexpensive, and often are generic, Berg explained, so it can be challenging to capture the attention of the big pharmaceutical companies. “We hope this list will help educate families that their children are potentially at risk and galvanize the public to pressure for legislative change and increased involvement from the Food and Drug Administration in preventing and managing shortages of essential cancer medicines.”

See a full list of contributors and funding support from the journal.