Generic carboplatin and cisplatin are inexpensive and indispensable. The platinum-based, injectable chemotherapeutic drugs have factored prominently in curative regimens and combination therapies that have significantly extended patients’ lives. By rights, they should be the poster children of cost-effective cancer care. Instead, they have become the focal points of a painful drug shortage in the United States that has dragged on since February 2023.

“This is the most critical chemotherapy shortage I’ve ever seen, and this is, certainly, a public health emergency,” says Angeles Alvarez Secord, MD, MHSc, director of gynecologic oncology clinical trials at Duke Cancer Institute in Durham, North Carolina. “It breaks my heart that you have cancer patients—or any patient for that matter—going through this.”

Drug shortages are a long-standing headache for hospitals, but the breadth and duration of the ongoing shortage in what another expert calls “bread-and-butter” oncology drugs have created an unusually acute crisis. The shortage has also renewed calls for government action that multiple providers and professional societies say is long overdue.

“It’s really mind blowing that we are here in 2023 dealing with pretty significant impacts on patients,” says Kirollos Hanna, PharmD, director of pharmacy at Minnesota Oncology and an assistant professor of pharmacy at the Mayo Clinic College of Medicine in Rochester, Minnesota. With cisplatin and carboplatin, he says, “We were at a point where we said, ‘No metastatic disease utilization.’ We said, ‘Find something else, even if the data are subpar.’ That’s all we had to work with, because we needed to be sure we were curing our bladder and testicular cancer patients.”

通用卡铂和顺铂价格低廉且不可或缺。以铂为基础的注射化疗药物在治疗方案和联合疗法中发挥着重要作用，显着延长了患者的生命。按理说，他们应该是具有成本效益的癌症治疗的典范。相反，它们已成为美国自 2023 年 2 月以来一直持续的痛苦药品短缺的焦点。

“这是我所见过的最严重的化疗短缺，这无疑是一个公共卫生紧急事件，”北卡罗来纳州达勒姆杜克癌症研究所妇科肿瘤临床试验主任、医学博士、理学硕士安吉利斯·阿尔瓦雷斯·塞科德 (Angeles Alvarez Secord) 说。“癌症患者——或者任何与此相关的患者——正在经历这样的事情，这让我心碎。”

药物短缺是医院长期头疼的问题，但另一位专家称之为“基本”肿瘤药物的持续短缺的广度和持续时间造成了一场异常严重的危机。这种短缺还再次呼吁政府采取行动，多家医疗服务提供者和专业协会表示，政府早就该采取行动了。

明尼苏达州肿瘤科药学部主任、明尼苏达州罗切斯特市梅奥诊所医学院药学助理教授、药学博士基罗洛斯·汉纳 (Kirollos Hanna) 表示：“2023 年我们面临着对患者相当大的影响，这确实令人震惊。” 他说，对于顺铂和卡铂，“我们当时说，‘不利用转移性疾病’。” 我们说，“寻找其他东西，即使数据低于标准。” 这就是我们必须要做的工作，因为我们需要确保我们正在治愈膀胱癌和睾丸癌患者。”