Shortages of several generic chemotherapy drugs are straining hospital supply chains and raising concerns that cancer centers may need to ration treatment for some patients, according to a June 24 New York Times report.
Manufacturing problems, shipping delays and decisions by some companies to stop producing the medications have contributed to shortages of carboplatin, cisplatin, oxaliplatin and ifosfamide — drugs that form the backbone of treatment for breast, lung, head and neck, ovarian, testicular and bladder cancers.
Hospitals and cancer clinics working with Premier, a company that negotiates discounts on drugs and supplies for about 4,200 health systems nationwide, have received only 38% of their ifosfamide orders and about two-thirds of their cisplatin orders, according to the report. Some providers have begun spacing out doses and scheduling patients consecutively to minimize drug waste, while others are prioritizing patients most likely to benefit from treatment. Florida Cancer Specialists and Research Institute told The Times securing supplies of carboplatin, cisplatin and oxaliplatin has been “very difficult.”
It is not the first time cisplatin and carboplatin have driven widespread rationing concerns — in 2023, more than 97% of hospitals surveyed said the carboplatin shortage was affecting patient care and pharmacy operations, triggered by quality failures at a single Indian manufacturer. As recently as November 2025, carboplatin and cisplatin were still identified as the most problematic shortages among 22 chemotherapy drugs in active short supply.
The FDA tracks all active shortages through its database and is considering temporarily allowing imports from manufacturers that do not typically supply the U.S. — a tool it previously deployed during the 2023 cisplatin crisis, when it authorized temporary importation from Chinese manufacturer Qilu Pharmaceutical.
The ifosfamide shortage traces to manufacturing problems at Simtra BioPharma Solutions, formerly Baxter Oncology GmbH, at its contract facility in Germany. The FDA issued Simtra a warning letter in March following a September 2025 inspection that found repeated microbial contamination in aseptic processing areas. The European Medicines Agency has separately warned that the facility is not expected to return to full capacity until early 2027.