US cancer centers continue to see chemotherapy shortages: Report

The National Comprehensive Cancer Network (NCCN) has released a follow-up survey on the ongoing chemotherapy shortages: 72% of the centers surveyed continue to experience a shortage of carboplatin and 59% are still seeing a shortage of cisplatin. Overall, 86% of centers surveyed reported experiencing a shortage of at least one type of anti-cancer drug.

The NCCN Best Practices Committee originally shared survey results in June 2023, which found that 93% of cancer centers surveyed at that time were experiencing a shortage of carboplatin and 70% lacked a steady supply of cisplatin. NCCN's follow-up survey was conducted September 6–20, 2023.

Both surveys focused on two platinum-based generic chemotherapy medications that are recommended for treating hundreds of different cancer scenarios according to the NCCN Drugs & Biologics Compendium (NCCN Compendium). The searchable database features every recommended use for cancer medication found in any of the evidence-based, expert consensus recommendations in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines)—the recognized standard for clinical direction and policy in cancer management.

"Everyone with cancer should have access to the best possible treatment according to the latest evidence and expert consensus guidelines," said Robert W. Carlson, MD, Chief Executive Officer for NCCN. "Drug shortages aren't new, but the widespread impact makes this one particularly alarming. It is extremely concerning that this situation continues despite significant attention and effort over the past few months. We need enduring solutions in order to safeguard people with cancer and address any disparities in care."

The September 2023 survey included responses from 29 out of NCCN's 33 Member Institutions—all leading academic centers from across the United States, which may not reflect any additional challenges experienced by smaller community practices serving rural and marginalized patients. Nearly all reported being able to continue treating every patient who needs carboplatin or cisplatin, despite lowered supply, primarily by implementing strict waste management strategies.

The survey results also revealed several other key medications that are currently in short supply, including 66% reporting a shortage of methotrexate, 55% for 5-flourouracil, 45% for fludarabine, and 41% for hydrocortisone.

"These drug shortages are the result of decades of systemic challenges," said Alyssa Schatz, MSW, Senior Director of Policy and Advocacy for NCCN.

"We recognize that comprehensive solutions take time and we appreciate everyone who has put forth proposals to improve investment in generics and our data infrastructure. At the same time, we have to acknowledge that the cancer drug shortage has been ongoing for months, which is unacceptable for anyone impacted by cancer today. These new survey results remind us that we are still in an ongoing crisis and must respond with appropriate urgency."

NCCN continues to advocate for solutions

NCCN released a statement on the shortage in June 2023, calling for action from the Federal Government and its agencies, the pharmaceutical industry, providers, and payers to work together to ensure quality, effective, equitable, and accessible cancer care.

Since then, the organization has worked with the White House, National Cancer Institute, Centers for Medicaid and Medicare, along with other oncology nonprofits to advocate for short- and long-term fixes.

"We are grateful for all of the progress that has been made since June, but we won't rest until we know we can prevent anti-cancer drug shortages from happening in the future," said Dr. Carlson.

View an overview of NCCN's findings to date on drug cancer shortages at NCCN.org/policy.