Covid-19 Lockdown and Cancer Drugs Shortage: Experience from an Oncology Center in Northern Nigeria

Abstract

Background: The advent of COVID-19 in December 2019 and its rapid progression to a pandemic has caused diverse health and economic challenges around the world. In order to mitigate this fast-spreading virus, the government of Nigeria imposed lockdown which further exacerbated the challenges already caused by the pandemic such as exhaustion of cancer drugs, difficulties in cancer drug production and distribution. This study aimed at identifying the presence of cancer drugs shortage due to COVID-19 lockdown, affected cancer drugs and the solutions proffered.
Methodology: This was a descriptive cross-sectional study carried out at an oncology center in northern Nigeria. Between March and June 2020, all patients receiving chemotherapy during the lockdown due to COVID-19 and were affected by cancer drug shortages were interviewed with a structured proforma when present for chemotherapy. Information on patient's personal data, clinicopathological characteristics, chemotherapy regimen, cancer drugs shortage experienced and solution proffered were obtained and data analyzed using Microsoft Excel sheet and result presented using simple tables.
Results: Sixteen of the 170 patients who had chemotherapy during the study period experienced drug shortages. Out of these patients, 4 had ovarian cancer followed by 3 patients each with cervical and lower limb cancer respectively. Cisplatin, Cyclophosphamide and Bevacizumab are the commonest drugs affected (5 each). Exhaustion of cancer drugs in the hospital oncology pharmacy as the reason for the drug shortage affected all the patients, while exhaustion of cancer drugs from neighbouring facility and break in the supply chain further affected 3 and 4 patients respectively. Outsourcing of cancer drugs was the solution for all patients (16) ab initio. The unavailable drug was substituted in 2 patients and the regimen continued without the unavailable drug in another 5 patients.
Conclusion: The COVID-19 lockdown in the study environment resulted in cancer drugs shortage and Cisplatin, Cyclophosphamide and Bevacizumab were most affected. The causes for these shortages were multifactorial with exhaustion of hospital stocks being the most significant causative factor. Delaying the administration of chemotherapy for a few days while the unavailable drug was sourced from neighboring facility were the main approach to resolving this problem.