Why vital chemotherapy drugs are in short supply in India

Two critical chemotherapy drugs, cisplatin and carboplatin, are currently in short supply across India due to a combination of factors. These include rising global costs of platinum, a key raw material, disruptions in shipping through West Asia, and domestic price caps. While some government hospitals have managed to stabilize their supplies, many private hospitals continue to struggle with shortages, leading to interruptions or delays in life-saving treatment for patients.

Government intervention has temporarily raised the ceiling rates for the two drugs by 50% to help restart domestic manufacturing lines. Cisplatin and carboplatin are essential in treating a wide range of cancers, including ovarian, head and neck, lung, and testicular cancers. The cost of platinum has more than doubled, making the existing price-controlled manufacturing rates financially unviable for companies.

Moreover, geopolitical conflicts and shipping constraints in West Asia have limited the import of raw materials from major global suppliers, leading several generic manufacturers to temporarily slow or halt production.

The shortage has been ongoing for nearly seven months, with significant impacts on cancer treatment. Leading oncologists highlight that the lack of cisplatin, a first-generation platinum drug, is particularly concerning, as it is the cheapest and widely used among the two. Alternatives are generally less effective, non-standard, and can carry higher costs or different toxicity profiles. This has led to treatment delays, changes in chemotherapy regimens, and increased stress for patients and their families.

However, some hospitals are reportedly doing better in managing the situation. The Regional Cancer Centre in Kerala, the Kidwai Memorial Institute of Oncology in Bengaluru, and the Delhi State Cancer Institute have adequate stocks and multiple procurement channels to ensure continuity of care. The government sector in several states seems to be coping better, with the Karnataka government and the Tamil Nadu Medical Services Corporation ensuring the supply of platinum-based drugs.

Nonetheless, the disruptions in the supply chain of these vital chemotherapy drugs continue to pose a significant challenge to cancer treatment in India.