How big cancer centers get the advantage in drug shortages

For months, oncologist Kristen Rice found herself scrambling for cisplatin and carboplatin, two key chemotherapies used for many different cancers including ovarian, bladder, and lung cancer. Like most small community practices, Rice’s clinic has always kept “just in time” inventory – or just enough stock to last the clinic the next few days. Pharmacy technicians would order more drugs each day to keep the clinic running until, one day, they couldn’t.

A pharmaceutical plant in India had been producing about half of the country’s supply of cisplatin until, in November of last year, it unexpectedly shut down due to quality control issues. The news crept under the radar until a few months later, Rice said, the drug was seemingly nowhere to be found.

“It came without warning. We went to put in our chemotherapy order, and our supplier said, ‘We don’t have any.’ It was like overnight. One day we had it, the next day we didn’t,” said Rice, who is a partner at Medical Oncology Associates of San Diego. Rice wasn’t sure where to turn for help. Even OneOncology, a medical organization that supports community oncology clinics, had trouble finding the drug for Rice.