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Drug shortages continue to plague the United States, compromising patient safety and placing additional strain on healthcare resources. The shortages encompass common drugs used to treat a range of conditions, from everyday infections to heart attacks.

The US Food and Drug Ad ministration (FDA) held a public meeting in February to assess whether stricter criteria are needed when considering oncology drugs for accelerated approval. Measures enacted in 1992 allow the FDA to grant accelerated approval for drugs targeted at unmet needs in cancer based solely on data from single-arm studies and relying on end points other than the standard metric of overall survival.

Patients with inoperable metastatic melanoma now have another treatment option as ipilimumab becomes the second immunotherapy drug approved by the US Food and Drug Administration (FDA) for the treatment of cancer. Fortunately for clinicians, ipilimumab also has a new, easier-to-pronounce name—Yervoy. Specifically, Yervoy is indicated for patients with unresectable metastatic melanoma that is newly diagnosed or progresses despite prior therapy.

Cancer treatment–induced diarrhea (CTID) occurs in 50% to 80% of patients receiving chemo therapy and 50% of patients undergoing radiotherapy. Older patients, women, patients on an irinotecan-containing regimen, and patients treated in the adjuvant setting are at higher risk of CTID, reported Kelly Markey, PharmD, BCOP. Markey is a clinical pharmacist with the gastrointestinal tumor program at Moffitt Cancer Center in Tampa, Florida, and discussed CTID at the annual meeting of the Hematology/Oncology Pharmacy Association.

The median age for someone to receive a cancer diagnosis is 67 years according to the Surveillance, Epidemiology, and End Results database and even higher for certain malignancies. For example, many gastrointestinal cancers are diagnosed in septuagenarians.

The Centers for Medicare & Medi caid Services (CMS) has re leased a proposed decision memo that suggests it will cover the cost of sipuleucel-T (Provenge), the immunotherapy vaccine approved in April 2010 for men with asymptomatic or mildly symptomatic metastatic castrate-resistant prostate cancer, for on-label use. CMS contractors will have discretion as to whether they will cover it for off-label use.

Every physician has a preferred way of writing prescription instructions, and pharmacists differ in how they translate those instructions to the pill bottle. A study published in the Annals of Internal Medicine by Wolf and associates found that the lack of a universal medication schedule (UMS) to standardize how prescriptions are written and filled contributes to poor patient adherence and increases safety concerns. Elderly patients or those with low health literacy are more prone to confusion when trying to follow a multidrug regimen.

The National Cancer Institute set out to answer this question last year and published results of their investigation in the January 2011 issue of the Journal of the National Cancer Institute. The study’s authors point to flaws in previous cancer cost estimates, many of which did little more than take figures from 15 years ago and adjust them for inflation.

The following is a list of drugs commonly used for patients with cancer that the American Society of Health-System Pharmacists (ASHP) classified as being in short supply in March. For some drugs, only certain doses or preparations are unavailable. Most shortages are attributable to manufacturing delays and/or increased demand. In some cases, the manufacturer discontinued the drug or offered no explanation for the short supply. A couple (ie, capecitabine [Xeloda] tablets and dexamethasone sodium phosphate) have been voluntarily recalled because of contamination concerns.