W Asia conflict, API shortage choke platinum-based chemo drugs’ supply

Ahmedabad/Vadodara/Rajkot: Krishnakant Parmar, an oral cancer patient undergoing chemotherapy, has seen his treatment altered because of the shortage. His regimen of high-dose cisplatin once every three weeks has been reduced to a low-dose schedule every two weeks. Reason? Short supply of platinum-based chemotherapy drugs such as cisplatin, carboplatin and oxaliplatin that has hit cancer treatment centres in Ahmedabad, prompting oncologists to warn of risks for patients with oral, gastrointestinal and cervical and other cancers.Suppliers have linked the disruption to shortages of active pharmaceutical ingredients (APIs), citing geopolitical tensions in West Asia and reduced availability for Indian drugmakers. Experts said manufacturing costs have also risen, affecting production.Large public and corporate hospitals had built up stocks of these medicines, but restricted supplies have depleted inventories, especially over the past 30 days.Dr Kaustubh Patel, senior head and neck oncology surgeon at HCG Cancer Hospital, said around half of the hospital's head and neck cancer patients require chemotherapy, with most receiving platinum-based drugs. "These are not post-treatment drugs; they are potent curative agents. We are rationalising drug use as much as possible with current stocks, but the situation needs emergency redressal," he said.Drug stockists in Ahmedabad said the disruption has persisted for the past few months. Sanjay Gandhi, a pharmaceutical supplier to major oncology centres in the city, said larger hospitals had procured stocks, but mid-sized hospitals were more affected."Against regular demand, supply is only about 20-25%. Rising costs are a major factor, as stockists are also buying at higher prices. Since these are essential drugs under National Pharmaceutical Pricing Authority control, the higher costs become unsustainable for manufacturers. Several of these medicines have no alternative, so we are procuring them from wherever possible," he said.Dr Somesh Chandra, senior surgical oncologist at KD Hospital, said platinum-based drugs account for a major share of chemotherapy treatment. "These drugs target the DNA of cancer cells. Supply of these drugs, particularly cisplatin, which is also used concurrently with radiotherapy, has been affected more than other platinum compounds," he said, adding that some hospitals may consider alternatives where possible.Dr Nahush Tahiliani, oncologist at Zydus Hospital, said patients would suffer if supplies do not improve. "The shortage has been going on for some time. These drugs are irreplaceable. Carboplatin, for example, is used extensively in chemotherapy for head and neck, lung, ovarian and breast cancers," he said.The impact appears less severe in some other cities. Kanak Gadhvi, chief pharmacist at Muni Seva Ashram in Goraj near Vadodara, said the facility was procuring the drugs at available rates to ensure patients were not affected. Sources said Vadodara currently has adequate stocks, though prolonged disruption could strain supplies.In Rajkot, Mayursinh Jadeja, president of the Rajkot Chemist Association, said stockists had not reported shortages of cancer drugs. Surgical oncologist Dr Nitin Tolia also said supplies in the city remained unaffected.(With inputs by Prashant Rupera in Vadodara and Nimesh Khakhariya in Rajkot)
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