The financial burden of drug shortages: 7 study takeaways

A six-month shortage of cisplatin, a drug used in the treatment of head and neck cancer, resulted in a 16% total cost increase for practices in the U.S. Oncology Network, according to a study presented Sept. 27-28, at the American Society of Clinical Oncology's 2024 Quality Care Symposium in San Francisco.

Researchers from 26 practices in The Woodlands, Texas-based U.S. Oncology Network analyzed drug administration data for the six-month periods before, during and after the cisplatin shortage, according to a Nov. 10 news release from The ASCO Post

The cisplatin shortage began in February 2023. Though the FDA declared an official end to the shortage June 28, 2024, the study defined the shortage period from February 2023 to August 2023. 

Here are seven takeaways from the study:

  1. Cisplatin utilization for head and neck cancers decreased by 15% during the shortage period compared to pre-shortage levels. The largest decrease (60%) was reported during June and July 2023.

  2. Of patients receiving cisplatin, 10% were given an alternative drug during the shortage.

  3. During the shortage, use of alternative therapies increased: carboplatin by 40%, paclitaxel by 24%, cetuximab by 15% and fluorouracil by 5.3%.

  4. The average cost per administration for each drug was:
    • Carboplatin: $14

    • Paclitaxel: $16

    • Cisplatin: $18

    • Fluorouracil:  $22

    • Cetuximab:  $2,607

  1. After the shortage, cisplatin use increased by 8% from its pre-shortage rate, carboplatin use dropped below its pre-shortage rate and cetuximab use rose by 12% from its pre-shortage rate.

  2. The use of cetuximab as an alternative to cisplatin resulted in a 16% total cost increase for the oncology network, affecting both payer costs and patient cost-sharing amounts.

  3. "Even temporary shortages of drugs can lead to lasting utilization changes and have long-term financial implications," authors of the study said.  "The impacts of drug shortages on treatment decisions, guideline concordance, costs and patient outcomes are apt for further investigation."

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