During the 2023 national carboplatin shortage, a quarter of chemotherapy allocation decisions at a major cancer health system didn't follow the formal policy — and men and patients at the main campus were more likely to receive the drug. A new JAMA Network Open study calls for better documentation, monitoring, and enforcement to ensure fairer distribution during future drug shortages.
When carboplatin — a widely used chemotherapy drug — ran short nationally in 2023, Dana-Farber Cancer Institute (DFCI) rolled out a formal allocation plan to prioritize patients most in need. But a new study published in JAMA Network Open found that the plan didn't always play out as intended. Across a 7-site health system in Massachusetts and New Hampshire, 26% of allocation decisions for 483 patients didn't align with the policy's priority framework.
The DFCI plan ranked patients 1–5, prioritizing those on curative-intent treatment with no viable carboplatin alternatives. While 74% of decisions matched the assigned priority categories, gaps in documentation — including missing priority categories for 31% of patients — made consistent enforcement difficult.
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Why it matters: Drug shortages are a recurring crisis in oncology, and how scarce treatments get distributed has real life-or-death stakes. This study shows that even well-resourced institutions can fall short — raising urgent concerns about equity and transparency in less-resourced settings.
