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A nationwide shortage of essential generic chemotherapy infusions is prompting oncology practices to consider allocation decisions, according to a June 24, 2026 report by Christina Jewett in The New York Times. The affected medicines, including cisplatin, carboplatin, oxaliplatin, and ifosfamide, are widely used treatments for breast, lung, head and neck, ovarian, testicular, bladder, and other cancers, often when no targeted alternative exists.
The Food and Drug Administration attributes the shortages to manufacturing problems, shipping delays, and decisions by some companies to stop producing the drugs. These decades-old sterile injectables are difficult to manufacture and are priced low in the United States, a combination that can make supply less stable. Premier, a group purchasing organization that contracts on behalf of roughly 4,200 hospitals and health systems, reported that 38 percent of member orders for ifosfamide and about two-thirds of orders for cisplatin were being filled.
The supply constraints are affecting utilization management and site-of-care planning. Some practices have spaced doses and grouped patient appointments to avoid wasting medication, while clinicians in Michigan have started prioritizing scarce doses of ifosfamide for patients considered most likely to benefit. For payers, the disruption highlights the role of intermediaries in a payment system that, as experts quoted in the article say, can alter supply and demand signals for generic injectables.
Several mitigation efforts are underway. The FDA said it is considering temporarily allowing imports from manufacturers that do not typically supply the United States. The Mark Cuban Cost Plus Drug Company has begun producing carboplatin and methotrexate at a Texas facility, with support in part from the nonprofit Angels for Change. One contract manufacturing site in Germany tied to ifosfamide supply received an FDA warning letter in March after inspectors found sterility problems, with the affected product estimated to return in October.
Sources in the article said prior shortages of the same drugs three years ago led to discussion but limited lasting policy changes.
