Lucknow: A 52-year-old oral cancer patient from Kanpur, Ram Prakash, has been unable to get cisplatin, a key chemotherapy drug, at KGMU for past two months because of a shortage at the hospital’s HRF pharmacy. Last month, doctors switched him to a costlier alternative. On Wednesday, he was again asked to buy cisplatin from the market, but could not find it.“I cannot afford treatment if I have to spend this much,” he said. He is among thousands of cancer patients facing treatment disruptions as cisplatin and carboplatin, two of the most widely used platinum based chemotherapy drugs, remain in short supply across Lucknow. Stocks have run out in most govt cancer hospitals and are scarce in private pharmacies as well. Wholesalers and oncologists attribute the shortage to rising metal prices, its limited availability and supply-chain disruptions amid the war between the US and Iran.A TOI survey of the city’s three major govt cancer centres—KGMU, RMLIMS and Kalyan Singh Super Speciality Cancer Institute (KSSSCI)—found severe shortages. KGMU has no stock of either cisplatin or carboplatin. RMLIMS has 168 vials of cisplatin but no carboplatin, while KSSSCI is also out of stock and awaiting a supply of 100 vials from a vendor.At RMLIMS, patient Raj Dulari, undergoing chemotherapy for cervical cancer, was unable to receive carboplatin after stocks were exhausted.KGMU’s HRF pharmacy requires around 1,000 vials of cisplatin and carboplatin every month. KSSSCI requires 700-800 vials, while RMLIMS needs about 170 vials of each drug per month. Patients are forced to search for medicines in the market, where supplies are also limited. Major online pharmacies have also reported little or no availability.Prof Sudhir Singh faculty at Radiotherapy department explained that both drugs are essential for treating oral, throat, cervical, lung, ovarian and testicular cancers. Around 200-250 of the 300 cancer patients visiting our OPD every day require a platinum-based drug as part of their treatment. The shortage is forcing them to modify standard chemotherapy regimens or use alternatives. “Alternatives are either significantly more expensive or supported by less clinical evidence,” he added.Medical superintendent of KSSSCI, Prof Varun Vijay, said alternatives such as cetuximab cost around Rs 17,000 per dose, increasing the financial burden on patients if cisplatin is unavailable. “Poor patients are affected the most due to shortage,” he added.President of the UP Chemist and Druggist Federation, Suresh Chandra Srivastava, informed that platinum prices have more than doubled over the past year due to supply shortages, strong industrial demand and geopolitical conflicts, forcing some manufacturers to cut production of drugs such as cisplatin, carboplatin and oxaliplatin.“Existing inventories have been exhausted and fresh consignments have not arrived. Manufacturers have informed traders that production has slowed because of the steep increase in raw material costs,” he said.Prof Vijay said it may still take another two to four months before the backlog is cleared and regular supplies resume.
