WASHINGTON — U.S. hospitals are preparing contingency plans for potential rationing of some chemotherapy drugs as shortages of several widely used cancer medicines continue to affect supplies, according to oncologists, hospital pharmacists and healthcare organizations.
The concerns center on shortages involving key generic cancer treatments, including platinum-based drugs such as carboplatin, which are used in a range of cancer therapies. The American Society of Health-System Pharmacists (ASHP) has reported ongoing shortages affecting chemotherapy medications, while the U.S. Food and Drug Administration continues to list several oncology drugs among products facing supply constraints.
Healthcare providers said this month that hospitals are monitoring inventories closely and reviewing allocation plans in the event supplies worsen. Some medical professionals have reported that institutions are holding regular meetings to manage limited drug availability and prioritize patients if necessary. Those accounts have been shared by clinicians in professional forums, although the extent of rationing varies by hospital and region.
The issue follows years of recurring shortages involving generic injectable cancer medicines. The American Society of Clinical Oncology (ASCO) said earlier this year that a severe shortage of frontline chemotherapy agents in 2023 led the organization to develop guidance and ethical principles for patient care during shortages. ASCO said those resources remain available should supply disruptions intensify.
Drug shortage experts and oncology groups have attributed recurring supply problems to manufacturing disruptions, supply-chain vulnerabilities and economic pressures affecting the production of older generic medicines. Cancer medications remain among the drug categories most vulnerable to shortages, according to healthcare organizations that track supply conditions.
Hospital pharmacists and oncologists have warned that prolonged shortages could force treatment delays, substitutions or other measures intended to conserve supplies. However, professional organizations have emphasized that hospitals generally seek to maintain standard treatment schedules whenever possible and reserve rationing measures for situations in which supplies become critically limited.
“Managing this shortage requires a systematic approach to inventory management, patient prioritization, clinical rationing, and communication,” a provider guidance document on the carboplatin shortage stated.
Federal regulators and industry groups continue to monitor the situation. ASCO said in April that the overall U.S. oncology drug supply remained stable despite broader concerns about global supply chains, though it noted that some distributors had reported increased purchasing requests and limited availability of certain products.
As of late June, healthcare organizations said no nationwide mandate for chemotherapy rationing had been issued. Hospitals and cancer centers continue to assess inventories, while regulators and professional groups monitor supplies of affected medicines. Details on how long current shortages may persist remain unclear.
