NCCN Survey: All Responding Cancer Centers Report at Least One Anticancer Drug Shortage as Ifosfamide Gaps Hit 94%
核心洞察
A new NCCN survey found 100% of responding member cancer centers are short at least one anticancer agent, with more than 20% short five or more medications.
Ifosfamide shortages were reported by 94% of centers, while carboplatin shortages returned at 71% and cisplatin at 16%, with BCG also scarce.
NCCN reported that 96% of surveyed pharmacy directors said national or state policies have not improved the shortage situation since 2023.
Every cancer center responding to a new National Comprehensive Cancer Network (搜索) (NCCN) survey is contending with a shortage of at least one anticancer agent, and more than 20% are managing shortfalls of five or more different medications, according to data published September 10, 2026. The findings, drawn from responses by pharmacy directors and other clinical and administrative leadership at NCCN Member Institutions in late August, document a shortage crisis that NCCN has now been tracking for more than three years.
Ifosfamide and Platinum Agents Lead the Shortfall
The most widely reported gap involves ifosfamide, a generic chemotherapy used across a range of malignancies including bladder, ovarian, testicular, and uterine cancers, soft tissue sarcoma (搜索), osteosarcoma (搜索), and several adult and pediatric leukemias and lymphomas. Ninety-four percent of responding centers reported a current ifosfamide shortage.
Platinum-based chemotherapies, which serve as the backbone of regimens for numerous tumor types, also remain constrained. Seventy-one percent of centers reported a carboplatin shortage — a return of shortfalls that first prompted NCCN to begin surveying its members in June 2023 — while 16% reported a shortage of cisplatin. The immunotherapy Bacillus Calmette-Guérin (搜索) (BCG) for bladder cancer (搜索) was in short supply for more than half of respondents.
Policy Response Seen as Stalled
Asked whether national or state policies have made drug shortages better or worse since 2023, 4% of surveyed pharmacy directors said the situation had improved, while 96% said it had stayed the same.
"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," said Crystal S. Denlinger, MD, Chief Executive Officer, NCCN. "The good news is the cancer centers in our network have developed internal strategies, task forces, and communications plans for keeping patient care and clinical trials on track. The bad news is that this takes time and attention that could be better spent on improving patient experiences and outcomes and adds additional stress to an already burdened system."
Mitigation Workload and Prior Authorization Burden
Sixty-one percent of responding centers said they required pharmacy- and physician-led mitigation strategies to keep all patients on a recommended dose and schedule. The majority implemented waste management strategies, while others explored alternative recommended regimens to deliver guideline-recommended care.
When treatment plans had to be modified, 90% of centers reported needing repeat prior authorization of the plan, significantly increasing the amount of work per patient and introducing the potential for a delay in care continuity.
Calls for Economic Incentives and Better Supply Information
NCCN leaders pointed to structural economic factors behind the recurring shortages. "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," noted Alyssa Schatz, DrPh, MSW, Vice President of Policy & Advocacy, NCCN. "That is something that advocates have been requesting for years. As one respondent noted: 'many oncology generics are clinically indispensable but economically unattractive. Without correcting that economic imbalance, shortages are likely to recur.'"
Schatz added that the survey results also illuminated a desire for better information around generics suppliers and requests for earlier notifications by manufacturers to the FDA.
NCCN is part of the End Cancer Drug Shortages Coalition (搜索), which brings together more than a dozen hematology/oncology nonprofits to address the issue and propose long-term solutions. The group issued a consensus statement in May 2026 outlining the ongoing problem and a list of policy proposals. The latest survey results and previous surveys are available at NCCN.org/drug-shortages.