As the Covid-19 pandemic escalates, the spread of the infection is putting increasing pressure on healthcare systems worldwide. While valuable medical resources are being diverted for management of the Covid-19 pandemic, there is a plausible concern that treatment of cancer patients could become overlooked or delayed, leading to deteriorating prognoses for this vulnerable population. The Covid-19 pandemic has already caused disruptions in global drug supply chains, and as the situation deepens, cancer drug shortages can arise as a result of these disruptions. Potential shortages of generic chemotherapies, in particular, could also lead to an increase in counterfeit cancer drugs, which would put the health and wellbeing of patients and the integrity of the healthcare systems into jeopardy. During these unprecedented times, it is important to ask what actions or initiatives could mitigate potential drug shortages and their impact on the treatment of cancer patients.

During the Covid-19 pandemic, both European and American health authorities have acknowledged disruptions in medical product supply chains and potential shortages of important drugs. While pharmaceutical production in China, the largest supplier of active pharmaceutical ingredients, will slowly resume, the manufacturing and distribution of critical cancer therapies could experience further disruptions.

Domestic manufacturers of generic chemotherapies represent an important part of the supply chain and are diversely affected by the ongoing pandemic. As countries are announcing their planned healthcare budgets for the management of Covid-19, the impact of unforeseen expenditure on other areas in the healthcare systems, such as funds for cancer therapies, will be an important development to monitor. While the manufacturers of generic chemotherapies are already under pressure due to low prices and difficult procurement processes dictated by governments, the Covid-19 pandemic could force some of these manufacturers to redirect their operations for the time being—or permanently.

With the potential shortages of cancer drugs, counterfeits could become a serious issue in both developed and developing countries. Regardless, drug shortages could push healthcare professionals to use less effective and more expensive alternatives to certain cancer therapies that form the backbone of treatment in various indications, which could lead to increased recurrences and climbing costs.

For many countries, potential shortages of cancer drugs during the outbreak of Covid-19 pandemic is an issue to be carefully managed. As a reaction, governments could be more inclined to stockpile or limit exportation of critical cancer drugs when there are shortages; however, while there are no serious cancer drug shortages yet during this pandemic, governments could also explore long-term solutions to implement. In 2019, the widespread shortages of vincristine, critical chemotherapy that is used in the treatment of acute lymphoblastic leukaemia, the most common cancer in children, led to the issuing of the Mitigating Emergency Drug Shortages (MEDS) Act in the US, which incentivised Teva Pharmaceuticals to reinitiate their manufacturing of vincristine. Similarly, preemptive government planning, raising manufacturing incentives, and relaxing drug procurement processes could be valuable initiatives during the pandemic to prevent shortages of cancer drugs. Other initiatives could also include forming National Essential Cancer Medicines Lists, and implementing communications across governments and industries to support the integrity of global medical supply chains. Lastly, the challenges due to the Covid-19 pandemic could create the opportunity to implement innovative technologies such as blockchain on a wider scale into the pharmaceutical supply chains, which would offer partial solutions for problems of distribution during the pandemic, and would help tackle the threat of increasing counterfeits of cancer therapies.