The National Comprehensive Cancer Network® (NCCN®) recently published updated data on the current impact of generic cancer medication shortages in the United States. The data come from survey responses from pharmacy directors and other clinical and administrative leadership at NCCN Member Institutions from late August. According to the results, 100% of responding cancer centers are experiencing a shortage for at least one anticancer agent; more than 20% of centers currently in shortage for five or more other medications.
A shortage of ifosfamide, which is used in the treatment of many cancers, including bladder, ovarian, testicular, uterine, soft tissue sarcoma, osteosarcoma, and several adult and pediatric leukemias and lymphomas, was noted by 94% of the responding centers. In addition, 71% of centers noted a shortage of carboplatin and 16% a shortage of cisplatin, both of which are key agents used as the backbone of regimens to treat many tumor types.
When asked if national or state policies have made the issue of drug shortages better or worse since 2023, 4% of pharmacy directors surveyed said it has gotten better; 96% felt it stayed the same.
“It is disheartening that we remain in the same situation, including recurring or continued shortages of some drugs, despite years of raising the alarm and providing insight about this disruptive and dangerous issue for cancer care in America,” said Crystal S. Denlinger, MD, Chief Executive Officer, NCCN. “The good news is the cancer centers in our network have developed internal strategies, task forces, and communications plans for keeping patient care and clinical trials on track. [But] this takes time and attention that could be better spent on improving patient experiences and outcomes and adds additional stress to an already burdened system.”
Crystal S. Denlinger, MD
Alyssa Schatz, DrPh, MSW
When asked how they are handling these shortages, 61% of responding centers noted they required pharmacy and physician-led mitigation strategies to keep their patients on a recommended dose and schedule, whereas others explored alternative recommended regimens to deliver guideline-recommended care. When treatment plans had to be modified, 90% of centers noted a need for repeat prior authorization of the plan, significantly increasing the amount of work per patient and adding in the potential for a delay in care continuity.
“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,” noted Alyssa Schatz, DrPh, MSW, Vice President of Policy & Advocacy, NCCN. “That is something that advocates have been requesting for years.”
NCCN first started surveying Member Institutions about drug shortage issues in June 2023. Results from the latest survey and previous surveys, are available at NCCN.org/drug-shortages.
NCCN is part of the End Cancer Drug Shortages Coalition. The group put out a consensus statement in May 2026 with a big picture look at the ongoing problem and a list of policy proposals for the future. Visit NCCN.org/drug-shortages to learn more.
