The water usually runs down the hill, but the spirit is able to climb!

Published in: Volume 6 / Year 2012 / Issue 3-4
Category: Editorial
Page: 2
Visits: 982 total, 1 today

As we present this issue of European Journal of Oncology Pharmacy (EJOP), the first European Conference of Oncology Pharmacy has already taken place in Budapest, Hungary, 27–29 September 2012. Over 500 delegates from nearly 50 countries attended the conference, and it was a great opportunity to forge connections between delegates. Europe seems to be as great in mind as it is in reality.

The European approach to friendships and collaborations is well known, and this was witnessed in the talks and presentations given at the conference. What emerged was a real sense of worldwide partnership between oncology pharmacists.

Many local delegates had the opportunity to participate. The scientific programme, which included clinical and practice streams, attracted more delegates than expected, and enabled best practice and experiences to be disseminated and shared.

In the next few issues of EJOP, we will give those who were unable to attend an opportunity to learn more about the outcome of the discussions and presentations. In the meantime, all members are able to read the abstracts online (, and are encouraged to establish contact with speakers who presented topics of personal interest.

The desire to integrate new ideas into daily practice is tempered by other unforeseen demands. The cancer drug shortage, for example, is continuing. Difficulties are occurring in other areas, for example, changes to package size and lack of availability of certain antibiotics and the need to find substitutes. For oncology, the issue is mutating into a problem.

In the US, the Community Oncology Alliance reported that nearly 98.9% of 525 clinicians surveyed experienced a shortage of a cancer drug in the previous year [1].

Availability of many different oncology drugs has been restricted. Thirty years ago, Germany was coined the ‘pharmacy of the world’; however, the shortage of only one drug, fluorouracil, used in nearly 30% of all treatments, brought the treatment of these patients to a near standstill. The deliveries proceeded some weeks later. The German Society for Oncology Pharmacy (DGOP) has since begun to collate data on this incident from all 700 pharmacies preparing cytotoxic drugs. These data are sent to the Ministry of Health in Berlin, Germany, each week to inform decision-making.

Shortage of drugs has also prompted EMA to take action. On 22 November 2012, the agency published a ‘reflection paper on medical product supply shortage caused by manufacturing practice compliance problems’ (EMA/590745/2012) [2]. A safety report of 23 September 2012 from the Institute for Safe Medication Practices was cited. It showed evidence that a disruption in the supply of medicines can lead to inter alia, a failure to treat. The report also highlighted that less desirable, often expensive, unfamiliar alternative medicinal products are being used, and that the potential for error and poorer patient outcomes has increased as a result of absent or delayed treatment. The increased incidence of preventable adverse events associated with alternative medicinal products or dosage forms was also underlined.

We cannot say that shortage of drugs will only occur in countries that are unable to pay the highest price. It is, in fact, monopolisation that drives companies to merge and consolidate production plants for one drug. This situation is incompatible with our goals of providing the best care for people with cancer.

Instead of improving our service based on increasing knowledge, the economic situation drives us to be only hunter after the daily needed drugs.

ESOP has to make its voice heard: its message to politicians should be that health is a basic human necessity, and it is a political responsibility to ensure that healthcare provision, particularly for people with cancer, should be affordable and accessible.

In view of these circumstances, I hope that this issue of EJOP will help increase knowledge of how pharmacists can play a role in improving health care.


1. Community Oncology Alliance [homepage on the Internet]. Drug Shortages Survey. 2012 [cited 2012 Dec 11]. Available from:
2. European Medicines Agency [homepage on the Internet]. Reflection paper on medicinal product supply shortages caused by manufacturing/good manufacturing practice compliance problems. 2012 [cited 2012 Dec 11]. Available from:

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