APHON Pediatric Chemotherapy-Biotherapy Renewal

Who should make decisions on the allocation of drugs during a shortage?

Pharmacist Physician Hospital administration Panel Ethics committee Nurse Parent Not sure

80% 83% 19% 42% 19%

4% 3% 7%

Adapted from “Physician Approaches to Drug Shortages: Results of a National Survey of Pediatric Hematologist/Oncologists,” by J. C. Beck, B. Chen, and B. G. Gordon, 2017, World Journal of Clinical Oncology , 8 (4), 336–342; table 2, p. 338 (https://doi.org/10.5306/wjco.v8.i4.336). Copyright 2017 by the authors. Licensed under CC-BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/legalcode.

Summary Drug shortages prevent clinicians from providing a reasonable standard of care. Drugs that are critical in pediatric oncology and that have contributed to a dramatic improvement in childhood cancer survival over the past 5 decades are among the scarcest drugs. It is essential that those making decisions on drug allocation be guided by established ethical principles and that institutions establish interdisciplinary drug allocation committees. Pediatric hematology/oncology nurses play a key role in advocating for and participating in such committees as well as ensuring that families receive current and reliable information about drug shortages and the subsequent plans for managing their child’s care. References American Society of Health-System Pharmacists. (2021). Drug Shortages Statistics. www.ashp.org/Drug-Shortages/Shortage-Resources/Drug-Shortages-Statistics Beck, J. C., Chen, B., & Gordon, B. G. (2017). Physician approaches to drug shortages: Results of a national survey of pediatric hematologist/oncologists. World Journal of Clinical Oncology , 8 (4), 336–342. https://doi.org/10.5306/wjco.v8.i4.336 Bunnell, D., Burke, S., Casey, M., Hartley, J., & Hubrig, C. (2020). APHON position paper on drug shortages . Association of Pediatric Hematology/Oncology Nurses. https://resources.aphon.org/view/455238775/2/ Decamp, M., Joffe, S., Fernandez, C. V., Faden, R. R., Unguru, Y., & Working Group on Chemotherapy Drug Shortages in Pediatric Oncology. (2014). Chemotherapy drug shortages