Results of a new survey from the National Comprehensive Cancer Network (NCCN) have shed light on the widespread impact of the current carboplatin and cisplatin shortages. In a separate statement, the NCCN called on the whole oncology community to work together on solutions.
Background
Carboplatin and cisplatin are platinum-based chemotherapies that are frequently used together for systemic treatment of cancer, often with the intent to cure. They have been proven to be highly effective across a variety of cancer types—including lung cancer, breast cancer, and prostate cancer as well as many leukemias and lymphomas. Both chemotherapy agents are indicated hundreds of times throughout the NCCN Drugs & Biologics Compendium, a searchable database of every recommended medication use found in the NCCN Clinical Practice Guidelines in Oncology. Carboplatin and cisplatin are estimated to be used in the treatment of as many as 500,000 patients with newly diagnosed cancer per year.
Mitigating the Consequences of the Shortages
“This is an unacceptable situation. We are hearing from oncologists and pharmacists across the country who have to scramble to find appropriate alternatives for treating their patients with cancer right now,” stressed Robert W. Carlson, MD, Professor Emeritus of Medicine (Oncology and General Internal Medicine and Medical Informatics) at the Stanford University Medical Center and Chief Executive Officer of the NCCN. “We were relieved by survey results that show patients are still able to get life-saving care, but it comes at a burden to our overtaxed medical facilities. We need to work together to improve the current situation and prevent it from happening again in the future,” he emphasized.
The statement from the NCCN’s Department of Policy and Advocacy outlined specific steps that can be taken by the Federal Government, pharmaceutical industry, primary care providers, and payers to help mitigate any impacts from the anti-cancer drug shortages.
The statement authors noted: “The causes and solutions to the recurrent anticancer drug shortages that deprive oncology patients of optimal therapy are multiple and fixable. Effective solutions require a whole of oncology effort if they are to be successful.”
Survey Results
In the new survey, investigators from the NCCN Best Practices Committee asked 27 NCCN Member Institutions serving patients with cancer across the United States to respond from May 23 to May 31, 2023. The results of the survey indicated that 93% of the centers that participated were experiencing a shortage of carboplatin and 70% of them were experiencing a shortage of cisplatin.
The investigators also discovered that 100% of the centers were still able to treat patients who required cisplatin without any delays or claim denials. However, for carboplatin, that number dropped to only 64% of the centers that were able to keep all current patients needing carboplatin on the regimen. Another 20% reported being able to continue the prescriptions for some but not all of the patients. Overall, 16% of the centers reported treatment delays as a result of needing to reobtain prior authorization for modified treatment plans, but none of them have been confronted with outright denials.
Additionally, the survey results uncovered that 40% of the centers have received information from manufacturers and suppliers on when availability for carboplatin and cisplatin should resume.
Conclusions
“These results demonstrate the widespread impact of the chemotherapy shortage,” highlighted Alyssa Schatz, MSW, Senior Director of Policy and Advocacy at the NCCN. “We hope that by sharing this survey and calling for united action across the oncology community, we can come together to prevent future drug shortages and ensure quality, effective, equitable, and accessible cancer care for all,” she concluded.
Disclosure: For the full results of the survey, visit nccn.org.
