Navigating Oncology Drug Shortages: Ethical Frameworks and Strategic Management

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Shortages cause critical treatment delays and increased costs in addition to ethical challenges for health care professionals (HCPs), who are charged with balancing patient welfare with fair resource distribution. In the cover story on page 4, author Karen M. Fancher, PharmD, BCOP, discusses ethical frameworks, such as accountability for reasonableness, for institutions and HCPs to manage drug allocation fairly and transparently. Additionally, Fancher notes that it is critical to train HCPs to manage the emotional and psychological stress that can be associated with decisions and challenges relating to these shortages in oncology.

In the peer-reviewed insights paper on page 15, authors Cassandra Perkey, PharmD, BCOP; Brooke Peters, PharmD, BCOP; Bradley Winegar, PharmD; Manale Maksour, PharmD, BCPS; Jenny Li, PharmD, BCPS, BCOP; and Melody Chang, MBA, RPh, BCOP, discuss the impact of drug shortages on the health care system. The article outlines strategies employed by American Oncology Network to manage these shortages, including interdisciplinary collaboration, inventory management, dose rounding, alternative drug regimens, electronic medical record optimization, and effective communication with stakeholders and patients.

In the peer-reviewed literature review on page 6, authors Richa Shah, PharmD, BCOP; Rebecca Pokorny, PharmD, BCPS, BCOP; Luisa Giannangelo, MBA, RPh; Cradesha Perry, PharmD, MBA; Adina Kagan, PharmD candidate; Yuxi Lei, PharmD candidate; Rezarta Lako, PharmD, BCPS; Jessie Modlin, PharmD, BCOP; and Kevin Pang, PharmD, provide an overview of data supporting the use of covalent Bruton tyrosine kinase inhibitors in chronic lymphocytic leukemia and important considerations when choosing among agents.

In the peer-reviewed original research paper on page 18, authors Monica Tadros, PharmD, BCPS, BCOP; Tiba Al Sagheer, PharmD, BCOP, BCACP; and Morgan Alvah, PharmD, discuss the benefits and implementation of subcutaneous (SC) daratumumab and hyaluronidase-fihj (Darzalex Faspro; Janssen Biotech, Inc) for multiple myeloma treatment. SC daratumumab offers reduced chair time, cost savings, and increased patient satisfaction compared with its intravenous counterpart, which requires longer infusion times and is associated with higher rates of administration-related reactions.

Addressing drug shortages in oncology requires comprehensive strategies and ethical frameworks to ensure equitable resource distribution and minimize treatment delays. By adopting interdisciplinary collaboration and optimizing management practices, institutions can better navigate the challenges posed by these shortages, ultimately improving patient outcomes.