Drug shortages disrupt care at leading US cancer centers
www.cidrap.umn.edu
Drug shortages disrupt care at leading US cancer centers
Drug shortages disrupt care at leading US cancer centers
Laine Bergeson33 minutes ago.
Resilient Drug Supply
All 31 leading cancer centers responding to a new survey reported shortages of at least one cancer drug, and nearly two-thirds said they resorted to mitigation strategies to keep patients on their recommended treatments.
But in many cases, those mitigation strategies weren’t enough. Ninety percent of centers reported that treatment plans had to be modified because of drug shortages, creating additional insurance hurdles that may have delayed care.
The survey, conducted by the National Comprehensive Cancer Network (NCCN) from August 4 to 27, 2026, asked pharmacy directors and clinical and administrative leaders at NCCN member institutions across the country about drug shortages and their impacts on care.
Shortages reshape treatment, research
Nearly all responding centers (94%) reported a shortage of ifosfamide, a generic chemotherapy drug used to treat a variety of cancers, including bladder, ovarian, testicular, and pediatric leukemias and lymphomas.Seventy-one percent reported shortages of carboplatin, and 16% reported shortages of cisplatin, two drugs that are foundational in treatment plans for many different tumor types. More than half of the centers said they were short of Bacillus Calmette-Guerin (BCG), an immunotherapy drug used to treat bladder cancer.
Other drugs in short supply, according to respondents, included oxaliplatin, docetaxel, dacarbazine, and tice.
Only 32% of treatment centers said they could provide all planned treatments at the intended dose and schedule without any modifications. Another 61% said they could maintain the original treatment plan by using mitigation strategies, while 7% said they could not treat every patient according to the original plan.
Twenty-eight of the 31 treatment centers (90%) described using mitigation strategies, with 79% saying they implemented measures to reduce waste and 43% noting that they restricted the use of existing supplies. Thirty-two percent used the lowest acceptable dose, and 21% scheduled treatments at the longest recommended interval.
Shortages affected research as well as treatment: 39% of centers reported that drug scarcity disrupted clinical trials.
Insurance hurdles, treatment delays
Shortage-related modified treatment plans often required treatment centers to re-engage with insurance companies, with 90% of centers saying they had to get preauthorization for the new treatment plans. Of those centers, 17% said the process delayed treatment.Most centers had established multidisciplinary committees to address the drug shortage problem. The committees track inventory, develop substitution and adjustment strategies, and create allocation criteria when supplies need to be rationed.
When asked about possible remedies for drug shortages, 91% of those surveyed supported offering tax incentives for generic-drug manufacturers. Fifty-seven percent favored better systems for evaluating generic-drug suppliers, and 48% supported exempting generic drugs from tariffs.
“Nearly every pharmacy director who responded to our survey would like to see economic incentives put in place to encourage high-quality manufacturing for generic cancer medications,” said NCCN Vice President of Policy & Advocacy Alyssa Schatz, DrPh, in an NCCN press release.
“That is something that advocates have been requesting for years. As one respondent noted: ‘Many oncology generics are clinically indispensable but economically unattractive. Without correcting that economic imbalance, shortages are likely to recur.’”