How Supply Chains Constraints Have Made Chemotherapy Drugs Cisplatin And Carboplatin Costlier?

It is a double whammy for cancer patients undergoing chemotherapy treatment in India as the ongoing shortage of medicines is now set to become compounded with a price rise.

The Centre's decision to allow a price increase for cisplatin and carboplatin, two of the most widely used chemotherapy drugs in the country, has brought attention to a growing problem that oncologists say has been building for weeks: a shortage of essential cancer medicines.

According to a News18 report, the government recently gave its in-principle approval for the use of special powers under the Drug Price Control Order (DPCO), 2013, to revise the prices of the two drugs. The move came after concerns were raised about their continued availability in the market. The decision followed reports from hospitals and pharmaceutical companies that rising costs were making the production of some medicines financially unviable.

Why are these drugs so important?

Cisplatin and carboplatin are among the most commonly prescribed chemotherapy medicines in India and are used in the treatment of several cancers, including lung, ovarian, bladder, head and neck cancers.

Dr Vashishth Maniar, Oncologist and Founding Director of MOC Cancer Care & Research Centre, said to FPJ, the importance of these medicines cannot be overstated.

"Nearly 70 per cent of cancer patients are on one of these two drugs. These are among the most important medicines in oncology today," he said.

According to Dr Maniar, the shortage has created anxiety among patients who depend on these drugs as part of life-saving treatment protocols.

"Imagine being in the middle of cancer treatment and suddenly being told that a critical medicine is not available. It can be extremely distressing for patients and their families," he said.

What prompted the government's decision?

The National Pharmaceutical Pricing Authority (NPPA) had received multiple applications from drug manufacturers seeking permission to increase prices.

The companies cited several factors, including:

Rising Active Pharmaceutical Ingredient (API) costs

Increased manufacturing expenses

Foreign exchange fluctuations

Reduced commercial viability of producing certain drugs

An inter-ministerial committee examined requests involving 82 formulations. Of these, only four medicines were considered urgent enough for immediate intervention. Cisplatin and carboplatin were among them.

The committee also took note of concerns raised by Tata Memorial Hospital regarding shortages of the two chemotherapy injections.

To address the issue, the Department of Pharmaceuticals approved the use of Para 19 of DPCO 2013, a special provision that allows the government to intervene when public health concerns require action beyond normal price-control rules.

Was the shortage caused by supply chain issues?

Initially, many hospitals believed the shortage was linked to global disruptions or delays in the supply of raw materials.

However, doctors later realised the problem was more complex.

"At first, we thought there could be delays in the availability of APIs because of international factors. These drugs are not difficult to manufacture and have been available for decades. But over time, it became clear that the economics of production had become a major issue," Dr Maniar explained.

He said hospitals began noticing supply constraints around three to four weeks ago.

During that period, healthcare facilities relied on leftover inventories and searched for stocks from distributors across different regions.

"Only recently did hospitals realise that residual stocks were running out and fresh supplies were not arriving," he said.

According to him, many hospitals are now either critically low on stock or have already exhausted their supplies.

Why does a price hike matter?

Government records indicate that the shortage was not simply a manufacturing problem but also a financial one.

With production costs rising and prices remaining capped, some manufacturers reportedly found it increasingly difficult to continue producing the medicines profitably.

As a result, supplies began to shrink.

The government's approval is intended to give manufacturers enough financial incentive to resume or increase production and restore availability.

The Department of Pharmaceuticals has asked the NPPA to assess actual increases in raw material costs before determining the final price revision.

A committee recommendation suggests that annual increases of up to 10 per cent from the last fixed price, subject to a ceiling of 50 per cent, could serve as a guideline.

Will cancer treatment become more expensive?

While the prospect of higher medicine prices may worry patients, oncologists say cisplatin and carboplatin remain relatively affordable compared to many other cancer drugs.

Dr. Maniar noted that a dose of cisplatin generally costs less than Rs 1,000, while carboplatin typically costs between Rs 1,500 and Rs 2,000.

"These are not drugs that cost tens of thousands of rupees. Even if prices rise by 20, 30 or 40 per cent, they are still likely to remain within reach for most patients," he said.

He added that the bigger concern is ensuring that patients have access to the medicines when they need them.

"This is not a medicine used only by a privileged few. It is a basic chemotherapy drug used by cancer patients across economic backgrounds. Availability is far more important than maintaining an artificially low price that ultimately results in shortages," he said.

Could the situation have been avoided?

Dr. Maniar believes earlier communication between manufacturers and policymakers may have prevented the crisis.

"It is unfortunate that the issue reached a stage where patients lost access to treatment before corrective action was taken. If production had become financially unviable, that should have been communicated and addressed earlier," he said.

He added that cancer patients ended up bearing the consequences of a problem that had been developing behind the scenes.

When will supplies return?

Even after the government's approval, the shortage is unlikely to disappear overnight.

According to Dr. Maniar, it typically takes three to four weeks to manufacture and distribute fresh supplies of these medicines.

That means hospitals may continue to face stock constraints in the immediate future before supplies gradually stabilise.

For now, doctors say the government's decision is a necessary step to ensure that one of the most important categories of cancer medicines remains available for the thousands of patients who depend on it every day.

Published on: Wednesday, June 10, 2026, 05:00 PM IST