New Delhi: Cisplatin and carboplatin, two chemotherapy drugs used to treat several common cancers in India, are in acute shortage across hospitals in the country, multiple oncologists in different states and pharmaceutical companies have told ThePrint.
“There is an acute crisis. Hospitals are nearing the end of their reserved stock in a day or two,” Dr Kanika Sood Sharma, director of Radiation Oncology at Dharamshila Narayana Hospital, New Delhi, told ThePrint Friday.
The two drugs are platinum-based chemotherapy agents that have been in clinical use for over four decades. Together they feature in treatment protocols for at least eight major cancer types including cervical, lung, ovarian, head-and-neck, breast, esophageal, bladder and endometrial.
They are part of the National List of Essential Medicines, meaning the government considers them critical to basic healthcare.
Globally, cancer ranks as a leading cause of mortality, responsible for 20 million new diagnoses and 9.7 million deaths in 2022. In India, it remains a severe public health crisis. The disease affects approximately 100 individuals per 100,000, and this rate is anticipated to climb steeply in the coming years. A significant proportion of those patients depend on one of these two drugs at some point in their treatment.
“It’s not easily available. We have to inform vendors in advance,” said Dr Rajinder Kaur Saggu, surgical oncologist at Max Hospital in New Delhi, who has been trying to secure carboplatin for her breast cancer patients for three to four months.
A senior oncologist and professor at All India Institute of Medical Sciences (AIIMS), New Delhi, who did not wish to be named, explained, “These platinum-based drugs are essential for treating several common cancers, and are often used before and after surgery as part of standard treatment.”
“Their shortage can delay treatment, reduce its effectiveness, and affect patients’ chances of survival and recovery,” he added.
How platinum prices broke the supply chain
Cisplatin and carboplatin are not made from a synthetic compound that can be replicated cheaply. Their active pharmaceutical ingredient (API), the part of the drug that acts on cancer cells, is chemically derived from platinum, a precious metal traded on global commodity markets.
The AIIMS oncologist said that the shortage reached critical levels in the past 30 days as the West Asia conflict intensified, compounding pre-existing vulnerabilities in the pharmaceutical supply chain that have been building since the cisplatin/carboplatin shortages first reported in 2023. “Sterile injectable generics like chemotherapy medications face the highest risk due to their low margins and reliance on imported ingredients. In a word it’s a policy failure,” he told ThePrint.
According to Dr Shyam Aggarwal, chairperson of Medical Oncology at Sir Ganga Ram Hospital, pharmaceutical companies have attributed the shortage to a sharp rise in the cost of imported APIs, while government-imposed price caps under the Drug Price Control Order (DPCO) have made manufacturing commercially unviable. As a result, many companies have reportedly stopped production, forcing patients to search for the medicines from alternative pharmacies and suppliers.
Between September 2025 and February 2026, the price of raw platinum in India rose from approximately Rs 3,900 per gram to close to Rs 8,000 per gram, nearly doubling over a period of six months.
Both cisplatin and carboplatin are listed under the Drug Prices Control Order, which means the National Pharmaceutical Pricing Authority sets a ceiling on how much they can be sold for. The NPPA revises these prices once a year based on the Wholesale Price Index, a broad measure of economy-wide inflation.
On 1 April 2026, it raised ceiling prices by 0.65 percent. For a drug whose primary raw material had just doubled in cost, a 0.65 percent revision changes very little.
Rajiv Singhal, general secretary of the All India Organisation of Chemists and Druggists, the largest body representing chemists and drug distributors in the country, with over 12.4 lakh members, said the immediate crisis is one of raw material availability rather than pricing.
“Manufacturers are making all efforts to procure the required raw materials and ensure the availability of these life-saving medicines. Supply is expected to normalize once raw material availability improves,” he said.
“In the interest of cancer patients, the Government of India may consider extending necessary support to facilitate the availability of these essential raw materials and help overcome the present shortage,” he added.
Potentially curable cases becoming unresectable
Cisplatin and carboplatin are used at multiple stages of cancer treatment, not just during chemotherapy infusions. They are administered before surgery, known as neoadjuvant therapy, to shrink tumours and make an operation viable, and after surgery as adjuvant therapy to reduce the chance of recurrence.
They are also combined with radiation in chemoradiation protocols, particularly for cervical and head-and-neck cancers, where the combination is the standard of care and has no established equivalent.
“Prolonged disruptions force clinicians to substitute with less effective regimens or delay treatment, both of which worsen outcomes,” the AIIMS oncologist said.
Adding, “For operable disease, neoadjuvant chemotherapy may be withheld, converting potentially curable cases into unresectable ones.”
Unresectable means a tumour or disease cannot be safely or completely removed through surgery, usually due to its large size, critical location, or extensive spread.
Both cisplatin and carboplatin are not freely substitutable for each other, and neither has an equivalent from a different drug class that replicates its effect across the range of cancers it treats.
“There is currently no direct substitute that can universally replace cisplatin or carboplatin across all indications,” said Dr Mandeep Singh Malhotra, director of surgical oncology at CK Birla Hospital, New Delhi. “In many cancers, these drugs remain the standard of care.”
Dr Ishaan Allahabadi, senior consultant in Surgical Oncology at Paras Health, Panchkula, Haryana, noted that the burden falls unevenly across geographies. Patients in Punjab and northern India who travel hours to reach a cancer centre have no secondary option if their hospital cannot source the drug.
“They have the fewest alternatives to fall back on,” he said.
In Bengaluru, Dr Shekar Patil, medical oncologist at HCG Cancer Hospital, who treats patients across Karnataka, said the shortage has already been affecting his practice for over two months.
“For the last two to three months we are not able to get platinum drugs. No effective alternative drugs are available. If this shortage continues, many of our cancer patients will not get effective treatment and their survival and outcome will be impacted significantly,” he told ThePrint.
The AIIMS oncologist called specifically for expediting domestic production, strategic stockpiling by national health programmes, and transparent supply-chain oversight.
“In the meantime, hospitals should prioritise the most vulnerable patients and be honest with others about what a delay means clinically,” Dr Ray said.
(Edited by Amrtansh Arora)
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