# A non-profit manufacturer for shortage-prone generic chemotherapy

Source: https://onco.cc/ideas/idea-cost-nonprofit-generic-oncology/  
OnCo record `idea-cost-nonprofit-generic-oncology` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Cisplatin and carboplatin cost a few dollars a dose yet ran short across the US in 2023 because too few makers found them worth producing; a non-profit maker with long-term hospital contracts would keep them on the shelf.

## Summary

Civica Rx showed that a hospital-owned non-profit can manufacture and stock essential generics under long-term, fixed-price contracts, stabilising supply of sterile injectables. Oncology generics (platinums, fluorouracil, methotrexate, vincristine) are cheap, old and shortage-prone because thin margins push manufacturers out. A dedicated oncology line, funded by hospital consortia and philanthropy, would hold safety stock and dual-source active ingredients. The saving is not the drug price but the avoided cost of substitution, delay and dearer alternatives when a shortage hits.

## Fields

- Kind: Idea
- Last checked: 2026-09-10
- Hypothesis: A non-profit oncology generics supplier holding six months of inventory for the ten most shortage-prone cytotoxics will cut shortage days for those drugs among member hospitals by more than 80% within three years.
- Rationale: The 2023 platinum shortage forced dose changes and substitutions in most US cancer centres; the fix is a supply model, not a scientific one.
- Proposed test: Member hospitals report shortage days, substitutions and spending on alternatives, compared with non-member hospitals in the same regions.
- Maturity: early-clinical
- Actor: philanthropy

## Sources

- Civica Rx: https://civicarx.org/
- FDA: drug shortages: https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages

## Connected records

- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Platinum agents](https://onco.cc/technologies/platinum/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Cisplatin](https://onco.cc/drugs/cisplatin/)
- companies: [Civica Rx](https://onco.cc/companies/civica-rx/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Prices and value](https://onco.cc/bottlenecks/b-drug-pricing/)

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