Cancer Drug Shortages Affect Patient Care in Most Hospitals

The national cancer drug shortages are impacting the treatment course of the majority of patients requiring them, a recent survey shows.

The United States currently faces national cancer drug shortages, including capecitabine, carboplatin, cisplatin, docetaxel, fludarabine, fluorouracil, and methotrexate.

These chemotherapy drugs, called cytotoxic antineoplastics, are a standard of care for a wide variety of cancer types, such as breast, bladder, endometrial, head and neck, lung, and ovarian cancers, among others.

A survey conducted by Vizient, a healthcare performance company, shows that the majority of patients who require these cancer medications have had their treatment courses impacted. That includes 85% of patients requiring cisplatin and 70% requiring carboplatin, fludarabine, or fluorouracil.

By substituting individual drugs within treatment regimens or switching to a different treatment regimen entirely, the ability to treat patients with cancer is being significantly affected by these current shortages. Both capecitabine and carboplatin are part of this shortage situation due to their ability to be used instead of fluorouracil and cisplatin, respectively.

- Vizient

The national shortage of these six cancer drugs was caused by the sudden suspension of products from the Intas Pharmaceuticals SEZ plant in India due to insufficient monitoring of safety procedures and the destruction of documents about the quality control program.

Since January 2023, these products have begun to be included on cancer drug shortage lists. Moreover, these medications have had a two-fold increase in units ordered by providers.

However, the report reveals that the number of unique outpatient oncology patients receiving chemotherapy has only slightly increased at about 1.5% growth quarter-over-quarter between January 2022 and March 2023.

The authors note that due to a lack of transparency into how long the supply chain disruption will continue, providers may consider ordering larger quantities than usual to meet patient care demands.

While quantities ordered by major cancer centers began to increase significantly in February 2023 once alternatives were depleted, for example, carboplatin instead of cisplatin, the quantities appeared to have moderated in April and May 2023.

Most of the oncology centers (97.2%) reported being affected by Carboplatin shortage, followed by cisplatin (94.4%) and fluorouracil (86.1%).

As a response to the supplier disruption, the U.S. Food and Drug Administration (FDA) approved the importation of cisplatin from China in June.

A total of 32 oncology providers participated in the survey, including 10 of the 33 members of the National Comprehensive Cancer Network, a not-for-profit alliance of leading cancer centers across the U.S.