(ChemotherapyAdvisor) – Cancer drug shortages continued to worsen over the past year for community oncology practices in the United States, with profound cost and clinical implications for patients, according to a newly-released Community Oncology Alliance (COA) survey of 200 practices representing more than 500 physicians.

“98.9% of the respondents reported experiencing a (cancer) drug shortage in the last year,” COA found. “Survey participants indicated that cancer progressed more quickly in more than 60% of patients as a result of drug shortages, and more than 70% of patients had more severe side effects as a result of drug shortages.”

More than half of respondents – 58% — reported that cancer drug shortages are worsening, and the survey results indicate that more than 80% of patients (and more than 90% of practices) face worsening financial burdens as a result. Drug substitutions necessitated by the shortages are creating “issues of optimal treatment” and “significantly higher costs” to patients, the survey results indicate.

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COA Executive Director Ted Okon blamed Medicare reimbursement rates for cancer drugs as one root cause of the shortage, saying they have “created pricing instability.”

“That has resulted in disincentives for manufacturers to produce these low-cost but vital generic cancer drugs, as well as to invest in manufacturing facilities for these products,” Okon explained.

“When treating ovarian cancer, a commonly used drug is leucovorin,” said Patrick Cobb, MD, an oncologist at the Frontier Cancer Centers and Blood Institute in Billings, MT. “The substitute is a branded drug that is readily available. The cost to Medicare for a dose of the branded drug is $2,000 and the cost to the patient is $520. This is an unacceptable consequence of the drug shortage crisis.”

Generic drug shortages are affecting many facets of US health care, from emergency department services to oncology, primarily because of persisting problems with manufacturing streams for sterile-injectable drugs.

In the USA, 4 of 5 cancer patients receive treatment in community oncology practices, the COA survey announcement noted. The Community Oncology Alliance is a nonprofit organization.