Cisplatin/Carboplatin Shortages Persist Across Majority of NCCN Cancer Centers

Robert W. Carlson, MD

Shortages of cisplatin and carboplatin have continued at the majority of National Cancer Center Network (NCCN) institutions, according to data from a follow-up survey conducted by NCCN.¹

Data from the follow-up survey, which included 29 of 33 NCCN member institutions that were polled between September 6 and 20, 2023, showed that 72% of these institutions reported shortages of carboplatin, and 59% had shortages of cisplatin. Overall, shortages of at least 1 anticancer drug were reported at 86% of institutions.

Despite this reduced supply, the NCCN said that nearly all surveyed cancer centers were successful in maintaining treatment regimens for all patients requiring carboplatin or cisplatin. The NCCN said this has been primarily achieved through the adoption of stringent waste management protocols and strategies to optimize the use of available resources.

The NCCN noted that these survey results may not fully capture the challenges faced by smaller or rural community practices that cater to underserved patient populations.

Additional results showed that surveyed institutions reported scarcities of other key therapies utilized in cancer treatment strategies, including methotrexate (66%), 5-flourouracil (55%), fludarabine (45%), and hydrocortisone (41%).

“Everyone with cancer should have access to the best possible treatment according to the latest evidence and expert consensus guidelines,” Robert W. Carlson, MD, chief executive officer of NCCN, stated in a news release. “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.”

In previously reported findings from the NCCN, a survey conducted with 27 NCCN institutions between May 23 and 31, 2023, found that 93% of cancer centers were experiencing a shortage of carboplatin, and 70% had a shortage of cisplatin.² Although all cancer centers were able to continue cisplatin-based regimens without any delays or claim denials, only 64% of centers reported an ability to keep all patients receiving carboplatin on their current regimen.

Both surveys were conducted in response to FDA alerts concerning shortages of cisplatin and carboplatin. The FDA initially reported the shortage of cisplatin on February 10, 2023, and the carboplatin shortage was subsequently communicated on April 28, 2023.^3,4

In June 2023, the NCCN issued a statement addressing the shortages and urged collaboration among various stakeholders, including the federal government and its agencies, the pharmaceutical industry, health-care providers, and payers.¹ The goal of the NCCN was to maintain the quality, effectiveness, and accessibility of cancer care.

The NCCN has worked jointly with the White House, National Cancer Institute, Centers for Medicaid and Medicare, and other nonprofit organizations within the oncology sector to advocate for short- and long-term solutions to address the challenges posed by the shortages.

“These drug shortages are the result of decades of systemic challenges,” Alyssa Schatz, MSW, senior director of policy and advocacy at NCCN, said in a news release. “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.”

References

1. U.S. cancer centers continue to see chemotherapy shortages, according to update from NCCN. News release. National Comprehensive Cancer Network. October 5, 2023. Accessed October 5, 2023. https://www.nccn.org/home/news/newsdetails?NewsId=4178
2. NCCN releases statement addressing ongoing chemotherapy shortages; shares survey results finding more than 90% of cancer centers are impacted. News release. National Comprehensive Cancer Network. June 7, 2023. Accessed October 5, 2023. https://www.nccn.org/home/news/newsdetails?NewsId=3970
3. Current and resolved drug shortages and discontinuations reported to FDA. FDA. Accessed October 5, 2023. https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Cisplatin%20Injection&st=c
4. Current and resolved drug shortages and discontinuations reported to FDA. FDA. Accessed October 5, 2023. https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Carboplatin%20Injection&st=c