{"entity":{"id":"idea-cost-nonprofit-generic-oncology","kind":"idea","name":"A non-profit manufacturer for shortage-prone generic chemotherapy","aka":[],"tldr":"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.","asOf":"2026-09-10","links":[{"label":"Civica Rx","url":"https://civicarx.org/"},{"label":"FDA: drug shortages","url":"https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages"}],"tags":[],"related":[],"cancers":[],"sections":["chemotherapy"],"technologies":["cytotoxic-chemotherapy","platinum"],"targets":[],"drugs":["cisplatin","carboplatin"],"companies":["civica-rx"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-drug-pricing","b-global-access"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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.","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","cost":"large","horizonYears":4},"route":"/ideas/idea-cost-nonprofit-generic-oncology/","neighbours":{"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"}],"company":[{"id":"civica-rx","kind":"company","name":"Civica Rx","route":"/companies/civica-rx/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-drug-pricing","kind":"bottleneck","name":"Prices and value","route":"/bottlenecks/b-drug-pricing/"}]}}