{"entity":{"id":"idea-reg-generic-chemo-strategic-reserve","kind":"idea","name":"A strategic reserve of essential generic cancer drugs to end recurring shortages","aka":[],"tldr":"Cancer patients have had treatments delayed because basic chemotherapy drugs ran out. Keeping a national stockpile, like for flu antivirals, would prevent this.","summary":"Shortages of cisplatin, carboplatin, methotrexate, fluorouracil and other essential generics recur every few years in high-income countries and chronically in LMICs, usually after a single manufacturer's quality failure. Several countries hold strategic reserves of antivirals and antibiotics; none holds oncology essentials. The proposal is a rotating national or regional reserve covering six months of demand for the 20 most shortage-prone oncology generics, with stock rotated through normal supply chains to avoid waste, procurement rules that require dual sourcing, and automatic release triggers.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (No incentive to repurpose cheap drugs): Pantziarka et al., The Repurposing Drugs in Oncology (ReDO) Project (ecancer 2014)","url":"https://doi.org/10.3332/ecancer.2014.442"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":["platinum"],"targets":[],"drugs":["carboplatin","paclitaxel"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-generic-repurposing","b-global-access"],"keyPapers":["paper-pantziarka-ecancermedicalscience"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Reserves eliminate treatment delays and dose modifications attributed to shortages of covered drugs and reduce shortage-related switching to inferior regimens to near zero.","rationale":"The drugs are cheap and stable, the shortage cost (delayed curative treatment) is very high, and the reserve approach has worked for other essential medicines; the barrier is only that no one has been made responsible.","test":"Establish a reserve for ten drugs in one country and compare shortage-related treatment delays with the prior three years and with peer countries.","maturity":"early-clinical","actor":"policy","cost":"medium","horizonYears":2},"route":"/ideas/idea-reg-generic-chemo-strategic-reserve/","neighbours":{"technology":[{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"paclitaxel","kind":"drug","name":"Paclitaxel / nab-paclitaxel","route":"/drugs/paclitaxel/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-generic-repurposing","kind":"bottleneck","name":"No incentive to repurpose cheap drugs","route":"/bottlenecks/b-generic-repurposing/"}],"paper":[{"id":"paper-pantziarka-ecancermedicalscience","kind":"paper","name":"The Repurposing Drugs in Oncology (ReDO) Project","route":"/key-papers/paper-pantziarka-ecancermedicalscience/"}],"roadmap":[{"id":"chemotherapy-roadmap","kind":"roadmap","name":"Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs","route":"/roadmaps/chemotherapy-roadmap/"}]}}