APHON Pediatric Chemotherapy-Biotherapy Renewal

dose or administration of a lower dose, which patients should receive a scarce drug, what constitutes an adequate reserve, and who makes these decisions. According to Decamp and colleagues (2014), the imperative to prevent and to manage drug shortages is based on two fundamental values: (1) the need to maximize the benefits of highly effective drugs and (2) the obligation to ensure equitable access across patients and patient groups. Decamp et al. (2014, p. e718) made the following recommendations grounded on ethical rationales, and those recommendations were published in a consensus statement in the Journal of the American Academy of Pediatrics : 1. Optimize and efficiently use supplies to reduce the likelihood of future shortages and mitigate their effects. 2. Develop explicit policies that give equal priority during a drug shortage to evidence-based use of chemotherapy agents whether patients are receiving treatment within or outside a clinical trial. 3. Create an improved, centralized clearinghouse for sharing information about drug availability and shortages. 4. Explore voluntary sharing of drugs at state, regional, and national levels. 5. Develop a strategy for ongoing stakeholder engagement regarding managing drug shortages, with specific emphasis on patients and patient advocacy groups. Positions and Recommendations APHON supports the following efforts, as stated in its 2020 position paper on drug shortages (Bunnell et al., 2020, pp. 2–3): ! promoting awareness of drug shortages through reliable information sharing ! a dvocating for strategies that minimize the impact of drug shortages on the quality of care ! cooperating and collaborating with healthcare institutions, consortiums, professional organizations, policy makers, and stakeholders in prioritizing the prevention and management of drug shortages ! advocating for federal, local, and institutional policy changes that address drug shortages and reduce their frequency and impact on patients and families ! d eveloping institutional policies that – describe the institution’s approach to the management of drug shortages – include ethical principles of decision making on drug allocation