Cancer drug shortages show no signs of easing

Clinical takeaway: Prepare for potential treatment disruptions and added administrative burden, as shortages of key oncology drugs remain widespread and may require mitigation strategies, regimen adjustments, and repeat prior authorizations.

Drug shortages have affected cancer care in the US for years, prompting NCCN to begin tracking the issue in 2023. The latest survey suggests little progress, with 96% of pharmacy directors reporting that shortages have remained about the same despite policy efforts.

According to a new NCCN survey of member cancer centers, 100% of responding institutions reported a shortage of at least one anticancer agent, and more than 20% said they were experiencing shortages of five or more medications. The most commonly affected drug was ifosfamide, cited by 94% of centers, followed by carboplatin (71%), BCG for bladder cancer (more than half of respondents), and cisplatin (16%).

Most centers reported being able to maintain recommended treatment doses and schedules only by implementing pharmacy- and physician-led mitigation strategies. Common approaches included waste-management measures, limiting use of available stock, and modifying dosing or treatment intervals. Overall, 61% of centers said mitigation efforts were required to keep patients on intended regimens.

The shortages continue to create operational challenges. When treatment plans were modified, 90% of centers reported that repeat prior authorization was often required, and 17% said reauthorization had resulted in treatment delays. Nearly three-quarters of centers had established multidisciplinary drug-shortage committees to monitor inventory, develop conservation strategies, and communicate interim protocols.

One notable finding: carboplatin shortages, which helped trigger NCCN's initial survey effort in 2023, have re-emerged, with 71% of leading academic cancer centers now reporting supply constraints.

Source: National Comprehensive Cancer Network (NCCN). (2026 Sep 10). NCCN 2026 Drug Shortage Survey Results