Updated Survey: NCCN Centers Say Chemo Shortage Has Ebbed Only Slightly

Treatment centers that make up the National Comprehensive Cancer Network (NCCN) report that the ongoing chemotherapy shortage has barely budged since early summer, with 86% experiencing a shortfall of at least 1 in a new survey.¹

NCCN’s latest survey, released October 5, 2023, was conducted September 6 through 20. It followed a similar one conducted in June, which found that 93% of the network’s centers were experiencing shortages of carboplatin and 70% did not have a steady supply of cisplatin.²

This time, 72% of centers reported they still see shortages of carboplatin and 59% have shortages of cisplatin.

Carlson

“Everyone with cancer should have access to the best possible treatment according to the latest evidence and expert consensus guidelines,” Robert W. Carlson, MD, said in a statement during his final week as CEO of 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.”¹

For the September 2023 survey, 29 out of NCCN’s 33 member institutions responded. As leading academic research centers from across the United States, these centers may actually be better positioned to secure chemotherapy supplies, so the results may not reflect additional challenges experienced by smaller community practices serving rural and marginalized patients.

Nearly all NCCN members reported being able to continue treating every patient who needs carboplatin or cisplatin, despite lowered supply, primarily by implementing strict waste management strategies.

Carboplatin and cisplatin are backbone therapies in scores of cancer regimens affecting up to 20% of patients, according to the National Cancer Institute.³ Over the summer, physicians have told The American Journal of Managed Care they have resorted to solutions that include less frequent infusions or substituting newer, more expensive novel therapies as first-line treatments, even if they are currently listed in NCCN guidelines for second- or third-line treatment.⁴

In some cases, care may be delayed as physicians and cancer centers must get new payer approvals for the revised treatment plans.

The chemotherapy shortage arose following the shuttering of a plant in India that manufactured generic cancer drugs. The shortage of cisplatin emerged first and quickly spilled over into carboplatin, which can be substituted for cisplatin.⁵

References

1. US cancer centers continue to see chemotherapy shortages, according to update from NCCN. News release. October 5, 2023. Accessed October 5, 2023. https://www.nccn.org/home/news/newsdetails?NewsId=4178
2. NCCN releases statement addressing ongoing chemotherapy shortages; share survey results finding more than 90% of cancer centers impacted. News release. June 7, 2023. Accessed October 5, 2023. https://www.nccn.org/home/news/NewsDetails?NewsId=3970
3. The “accidental” cure—platinum-based treatment for cancer: the discovery of cisiplatin. National Cancer Institute. Published May 30, 2014. Accessed October 5, 2023. https://bit.ly/3RGGBWq
4. Caffrey M. How antibody conjugates and chemotherapy shortages are affecting patients with bladder cancer. AJMC. August 4, 2023. Accessed October 4, 2023. https://bit.ly/3tojWUH
5. Kim SE. Why there’s a serious cancer drug shortage and how to fix it. Scientific American. September 18, 2023. Accessed October 5, 2023. https://bit.ly/3F3jDRI