Cancer Drug Shortages Show Little Improvement in Fourth Year, New NCCN Survey Finds

More than three years after cancer centers first sounded the alarm on chemotherapy shortages, the problem still hasn't gone away, according to a new survey from the National Comprehensive Cancer Network (NCCN).

The survey, which gathered responses from pharmacy directors and other clinical and administrative leaders at NCCN Member Institutions in late August, found that every single responding center is currently dealing with a shortage of at least one anti-cancer medication. More than 20% of centers reported being short on five or more different drugs at once.

"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," Dr. Crystal S. Denlinger, chief executive officer of NCCN, said in a statement.

Which Drugs Are in Short Supply

Several widely used chemotherapy drugs were flagged as particularly hard to come by.

Ifosfamide, a generic chemotherapy used to treat bladder, ovarian, testicular and uterine cancers, soft tissue sarcoma, osteosarcoma, and several types of leukemia and lymphoma in both adults and children, was reported as being in shortage by 94% of responding centers.

Carboplatin, a backbone chemotherapy drug used across many tumor types, was in shortage at 71% of centers — a resurgence of a shortage that first drew national attention in 2023. Cisplatin, a related drug, was short at 16% of centers.

More than half of centers also reported a shortage of Bacillus Calmette-Guérin (BCG), an immunotherapy that's a standard treatment for certain types of bladder cancer.

What This Means for Patients

When a cancer center can't get enough of a drug, oncology teams don't simply stop treating patients — but the workarounds come with real costs. According to the survey, 61% of centers said they've had to put pharmacy- and physician-led strategies in place just to try to keep patients on their recommended dose and treatment schedule. That can include using medication more conservatively to reduce waste or switching patients to alternative regimens that still follow treatment guidelines.

Those changes create ripple effects of their own. Ninety percent of centers said that when a treatment plan has to be modified because of a shortage, it requires a new round of prior authorization from insurers — adding paperwork, delays and stress at a moment when patients and care teams can least afford them.

Asked whether state or federal policy changes have made shortages better or worse since 2023, only 4% of pharmacy directors said things had improved. The remaining 96% said the situation has essentially stayed the same.

Calls for a Policy Fix

NCCN's survey pointed to a root cause that's been raised repeatedly by oncology groups: many of the generic drugs at the center of these shortages are inexpensive and clinically essential, but not especially profitable to manufacture, which can discourage the kind of investment needed to keep supply chains stable.

"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," said Alyssa Schatz, vice president of policy and advocacy at NCCN. "As one respondent noted: 'Many oncology generics are clinically indispensable but economically unattractive. Without correcting that economic imbalance, shortages are likely to recur.'"

Survey respondents also said they want earlier notification from manufacturers when a shortage is coming, along with better transparency about who supplies which generic drugs — information that could help hospital pharmacies plan ahead rather than scramble after the fact.

NCCN is part of the End Cancer Drug Shortages Coalition, a group of more than a dozen hematology and oncology nonprofits pushing for long-term solutions to the shortage problem. The coalition released a consensus statement in May 2026 laying out policy proposals aimed at stabilizing the generic cancer drug supply. NCCN first began surveying its member institutions about drug shortages in June 2023, amid concerns over carboplatin and cisplatin supply. Full survey results are available at NCCN.org/drug-shortages.

References

1. National Comprehensive Cancer Network, PR Newswire, Sept. 10, 2026.

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