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The ongoing conflict in West Asia has severely disrupted the supply of key Active Pharmaceutical Ingredients (APIs), impacting the domestic pharmaceutical sector. To address these shortages, the government has authorised a price hike for essential medications, including the cancer drugs Cisplatin and Carboplatin, as well as two anti-tetanus immunoglobulin injections.
There were 82 Applications for price rise. The inter-ministerial committee recommended only four as above. According to the copy of the notification, the prices of Cancer drugs Cisplatin and carboplatin have been revised, In its notification, the government said, "The Authority noted that NPPA has been receiving requests for upward price revision of various drugs under para 19 of DPCO, 2013 from the manufactures citing various reasons like increase in cost of Active Pharmaceutical Ingredients (APIs); increase in the cost of production; change in exchange rate etc.; resulting in unviability in sustainable production and marketing of the drugs. Companies have also applied for discontinuation of some of the formulations on account of their unviability." Recently, ANI reported that chemotherapy drugs have disappeared from the market and the government has given a go-ahead after seeing the price rise of platinum. The pharmaceutical companies are going into losses and have stopped manufacturing and started stocking drugs. "NPPA has sort it's opinion from DOP regarding prices of 82 medicines which were checked by the interministerial committee where the request have been made for an increase in the price of medicines of the war crisis." said sources Top experts from Hospitals like AIIMS, Tata Memorial Cancer Hospital and Private Cancer Hospitals told ANI about the shortage of chemotherapy drugs leading to delays and a threat to cancer patients. According to the top Expert from AIIMS Delhi, these drugs play a crucial role in the treatment of cancer, such as head and neck, lung, ovarian, bladder, and gastrointestinal cancers. "I view the reported shortage of cisplatin and carboplatin as a critical threat to cancer care. These platinum-based agents are backbone drugs in treating common malignancies, head and neck, lung, ovarian, bladder, and gastrointestinal cancers. In my practice, I frequently integrate them with surgery as HIPEC and in multimodal protocols; their absence compromises neoadjuvant and adjuvant strategies, directly impacting survival and recurrence rates," said AIIMS expert. He warned that these disruptions could compromise patient care, as shortages may force clinicians to switch to less effective treatment regimens. "Prolonged disruptions force clinicians to substitute with less effective regimens or delay treatment, both of which worsen outcomes. For operable disease, neoadjuvant chemotherapy may be withheld, converting potentially curable cases into unresectable ones. In palliative settings, symptom control and quality of life deteriorate without adequate systemic therapy. We need immediate intervention: expediting domestic production, strategic stockpiling by national programs, and transparent supply-chain oversight. Till then, patient counseling must be honest about risks, and multidisciplinary teams must prioritize the most vulnerable cases. This crisis reminds us that surgical oncology cannot succeed without reliable access to essential chemotherapy," added the AIIMS Expert. Rajiv Singhal, General Secretary of the All India Organisation of Chemists and Druggists (AIOCD), stated that the shortage of Cisplatin and Carboplatin stems from the limited availability of platinum-based raw materials. The drugs Cisplatin and carboplatin are linked to the shortage Beauregard of limited availability of platinum based raw material. "The current shortage of Cisplatin, Carboplatin and certain other oncology medicines is primarily linked to the limited availability of platinum-based raw materials globally over the past few months. Industry sources have indicated that this is a supply-chain challenge and not a pricing issue. Manufacturers are making every effort to secure adequate raw materials and restore normal supplies. Considering the critical importance of these medicines for cancer treatment, we urge the Government of India to facilitate the availability of essential raw materials so that patients do not face any disruption in therapy." said Singhal. Dr. Mansi Khanderia, Senior Consultant (Medical Oncology) at SPARSH Hospitals, Bengaluru, cautioned that any delay in the availability of these medicines could directly impact treatment timelines, as these drugs form the foundation of care for several types of cancer, including lung and ovarian cancer. "Shortage of some essential chemotherapy drugs like cisplatin and carboplatin is a very serious concern since these medicines form the foundation of treatment for several kind of cancers, including lungs, ovarian, bladder, head and neck and testicular cancers as well. Any delay or disruption in their availability can directly impact timelines of treatments, outcomes and confidence of patients. Cancer related care is very time sensitive, and patients should not have to face uncertainty around access to life saving medicines. There is also a urgent need for stronger supply chain planning, transparent level of monitoring, and well-coordinated access to ensure uninterrupted availability of critical cancer drugs for every kind of patients who needs them," she said. Dr. Niti Raizada, Principal Director of Medical Oncology and Hemato-Oncology at Fortis Hospitals, Bengaluru, warned that oncologists may be forced to consider alternative treatment regimens depending on a patient's specific condition and cancer type. She however cautioned that these alternatives may not always match the efficacy or suitability of the standard platinum-based protocols. "Cisplatin and Carboplatin are among the most important and widely used chemotherapy drugs in oncology. They form the backbone of treatment for several common cancers, such as lung, head and neck, cervical, ovarian , bladder, and testicular cancers. In many situations these medicines are used with a cure driven intent , so they play a crucial role in improving survival and overall treatment outcomes. The patients who would feel any shortage the most are typically those already undergoing active chemotherapy, especially people with newly diagnosed cancers, patients receiving simultaneous chemoradiation, and those whose treatment protocols specifically ask for platinum-based drugs. When limited availability happens it can seriously slow timely cancer care and disrupt treatment planning...Yes, shortages of these drugs can disrupt treatment schedules. In some situations, chemotherapy cycles may need to be delayed until the medication becomes available, while in others, oncologists may have to consider alternative treatment regimens based on the patient's condition and cancer type. However, alternatives may not always offer the same level of evidence or suitability as the standard platinum-based protocol. Such disruptions can create significant anxiety for patients and clinicians alike, particularly when treatment is being given with curative intent, where maintaining the planned schedule is extremely important for achieving the best possible outcomes," said Dr. Niti Raizada. Dr. Shyam Aggarwal, Chairperson of Medical Oncology at Sir Ganga Ram Hospital, noted that the medical community has engaged with pharmaceutical companies regarding the critical shortage. Highlighting that 60-70% of patients with advanced cancer require Cisplatin or Carboplatin, he appealed to the Government of India to incentivise and facilitate domestic production of these essential drugs to ensure their availability. " In the entire country we are facing shortage of two extremely potent and commonly used anti-cancer drugs the names being cis-platinum and carboplatinum. There is a acute shortage of these drugs we are facing for the last two to three weeks and now in the pharmacy of our hospital and our you know sister hospital we don't have the availability of cis-platinum and carboplatinum. So these two drugs are extremely potent and they are used in first-line therapy for a variety of cancers which are common in India like lung cancer, oral cancer, cervix cancer, uterine cancer, ovary cancer, testicular cancer and so on," he said. "So nearly 60-70% of patients who have advanced cancer they do require cis-platinum or carboplatinum. So since we've been facing this difficulty for the last two three weeks we started to discuss this matter with the pharmaceutical companies as to why it is short and the explanation being given by the companies is that these two drugs come under DPCO where the government has fixed an MRP and so the problem which has happened possibly due to the Gulf War that the API that is the you know active ingredient is imported from South Africa and Russia and other countries so because of the shortage of that product the price has gone up of the API and unfortunately as a result of that the cost of manufacturing cis-platinum and carboplatinum has increased but then that doesn't match the MRP fixed by the government of India because of the DPCO product. So we are facing and patients are suffering because of lack of availability of these two drugs so patients are asked to procure their own drug from whatever source maybe from other companies or from other pharmacies where there's some stock you know pending has not been used because most of the companies have stopped manufacturing cis-platinum and carboplatinum," he added. "So I think it's an extremely important issue because these two drugs are life-saving and very very commonly used in most of the common cancers worldwide. So I appealed to the government of India to look into the matter and you know request the pharma companies to start manufacturing the cis-platinum and carboplatinum so that the patients do not suffer." Dr Shyam Aggarwal further said. (ANI)
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