With Drug Shortages and Errors on the Rise, Oncology Pharmacists are Vital to Navigate Treatment in the Era of a Pandemic
Drug shortages and medication errors are continual issues for cancer patients, with shortages preventing patients from obtaining the care they need and errors contributing to dire consequences for patients. A report from the Institute of Medicine titled “Frequency of chemotherapy medication errors: A systematic review” estimates that medication errors with chemotherapeutic drugs are the second most common cause of fatal medication errors in the United States. With the rise of drug shortages and errors, oncology pharmacists have become trusted and essential members of the patient care team.
Oncology continues to see rapid growth in the treatments for cancer and evolving alongside is the expanding role for oncology pharmacists in delivery of care. With each new approval and new indication, oncology pharmacists help to bridge the gap between science and real-world medical practice. Oncology pharmacists bring expertise in the most effective medication use, implementation of safe medication practices, reimbursement processes, medication management, supportive care, immune-related adverse events, and training and education.
Cancer treatment can be an overwhelming experience for patients and their family members. The medications used to treat and support patients with cancer can have significant adverse effects, and patients often have questions about their course of treatment and management of these effects. The current pandemic presents additional considerations for selection of therapeutic options, monitoring and supportive care, including integration of vaccine(s). Oncology pharmacists are uniquely qualified to provide specialized care to patients with cancer to optimize medication therapy and clinical outcomes. These advanced focused pharmacists play an integral role in the treatment and supportive care of cancer patients.
Oncology drugs have a high cost, high toxicity, and high sensitivity. As such, the management and prevention of problems is particularly important, especially in terms of the patients' state of health. Drug shortages and barriers to medication access pose serious risks to the health care system. Oncology drug shortages can threaten a patient’s safety by creating delays in chemotherapy treatments, changes in the dose or combination of drugs needed, or even missed treatments when drugs are not available, according to the National Survey on the Effect of Oncology Drug Shortages in Cancer Care. Concerns about receiving treatments in clinics and the risk of potential exposure during a pandemic present additional barriers that can result in delays in care. When delays in care occur, the oncology pharmacist plays a large role in making sure the patient is safe, making the pharmacist an integral member of the cancer care team. Drug shortages have an impact on our national healthcare system and hospitals, and they place a strain on our limited healthcare resources. At a time when there is a national focus on healthcare spending, the oncology pharmacist serves as a resource to optimize spending while maintaining a high quality of care.
Cancer treatments continue to evolve and improve patients’ lives. Oncology drug shortages present unique challenges, as many times there are not alternative treatments available. Further policy actions are needed, such as necessary economic incentives to return to a stable and consistent oncology drug supply. Oncology pharmacists play a valuable role in addressing the growing oncology shortages to minimize impact to patient care and optimize medication safety.
Dr. David DeRemer, PharmD, BCOP, FCCP, FHOPA
Dr. Susie Liewer, PharmD, BCOP, FHOPA
Past President, HOPA
The Hematology/Oncology Pharmacy Association (HOPA) is a nonprofit professional organization of more than 4,100 members. HOPA’s purpose is to optimize the care of individuals affected by cancer through the support and advancement of oncology pharmacy practice. HOPA is the leading oncology pharmacy association focusing on efforts to maintain quality and safety in cancer care in an interdisciplinary, collaborative practice setting including, but not limited to, hospitals, clinics, physicians’ offices, community pharmacy, and home health. The roles of our membership span from direct patient care, to education and research. HOPA leads efforts to ensure that the needs and perspectives of cancer patients and their families are maintained regardless of practice setting and that all cancer patients have access to quality and safe cancer care. In order to reach these goals, we have outlined priority areas for continued investment in cancer patients, cancer care, and research.