Dr Santos on Steps Taken to Address the Chemotherapy Shortage in the United States

Edgardo Santos MD, FACP, FCCP, clinical affiliate associate professor, Charles E. Schmidt College of Medicine, Florida Atlantic University, treasurer, Florida Society of Clinical Oncology, discusses how cancer centers across the United States are minimizing the negative effects of the ongoing carboplatin and cisplatin shortage, and details potential next steps that should be taken to prevent drug shortages like this from occurring in the future.

The nationwide platinum chemotherapy shortage has raised varying concernsacross the United States in relation to an oncologist’s ability to treat patients with cancer with the most effective care available, Santos begins. These agents are currently a standard treatment approach across multiple tumor types and have been shown to have curative-intent in certain settings, Santos says. Accordingly, lack of access to a potentially curative therapy can significantly worsen patient outcomes.

Although all 27 member institutions included in the National Comprehensive Cancer Network's (NCCN) Practices Committee Carboplatin and Cisplatin Shortage Survey were able to treat patients who need cisplatin without any delays or claim denials, only 64% were able to continue providing carboplatin to patients being treated with a carboplatin-containing regimen as of May 31, 2023.

For patients who did not fall into a prioritized disease category, many institutions had to adjust their prescribed regimen to account for the platinum shortage, Santos says, adding that this had the potential to result in delays or denials of treatment. According to the same NCCN survey, the need for prior authorization to modify patients' existing treatment plans delayed treatment at 16% of institutions, although no outright denials were reported.

Although collaboration between drug suppliers, institutions, and regulatory agencies are beginning to ameliorate the worst of the crisis, work still needs to be done to ensure that standard chemotherapy agents remain available and accessible, Santos emphasizes. Chemotherapy shortages are not a new problem, and several have occurred in the last decade, Santos notes. Additionally, many highly effective agents have available generic versions and expired patents, which should enable them to be more easily produced, Santos says. Therefore, experts are calling for legislation to account for manufacturing delays and increases in demand to prevent future drug shortages not only in the United States, but globally, Santos concludes.