Journal of Cancer Research and Pharmacology

Journal of Cancer Research and Pharmacology

Allocation and distribution of anticancer drugs in the supply chain and crisis management under drug shortage conditions: A narrative review

Document Type : Review

Authors
1 Department of Civil Engineering, Islamic Azad University, Neyshabur Branch, Neyshabur, Iran
2 1. Dr. Schneiderhan GmbH and ISAR Klinikum Munich, Germany 2. Department of Health Care Management and Clinical Research, Collegium Humanum Warsaw Management University Warsaw, Poland
Abstract
Cancer remains a leading cause of morbidity and mortality worldwide, and sustained access to anticancer medicines is indispensable for achieving curative and life prolonging outcomes. Yet global shortages of oncology drugs, especially off patent sterile injectables, have grown in frequency and duration, exposing structural fragilities across manufacturing, economics, regulation, and logistics. This narrative review synthesizes evidence on how scarce anticancer medicines are allocated and distributed during shortages, how systems manage crises, and where artificial intelligence (AI) and quantitative modeling can strengthen resilience. We summarize convergent drivers (quality related production halts, concentrated supplier bases, low margin tendering, demand shocks, regulatory bottlenecks, cold chain constraints, and external disruptions) and their uneven impacts across high income versus low- and middle-income settings. We then integrate multilevel strategies: nationally, early warning systems, critical medicine lists, diversified sourcing, and transparent stockpile release; within health systems, multidisciplinary governance, real time dashboards, conservation practices (dose rounding, vial sharing), internal redistribution, and consistent communication; and at the bedside, ethically grounded triage that prioritizes curative intent, higher expected benefit, and lack of alternatives. We map the emerging AI toolkit, including shortage forecasting, inventory optimization, supplier risk scoring, and digital twins to test allocation policies ex ante, and align it with four modeling families central to decision making under scarcity (mixed integer and stochastic optimization, discrete event and agent-based simulation, reliability and resilience modeling, and decision analytic and ethical frameworks). We conclude with a Prevention, Preparedness, Response, Recovery roadmap that links macro level incentives (resilience-oriented procurement and quality and continuity rewards), meso level data infrastructure and playbooks, and micro level shared decision making. Priorities include harmonized metrics for shortage severity and resilience, prospective evaluations of allocation policies, and cross-country collaboration to ensure that digital and analytic advances enhance equity while reducing the clinical harm of oncology drug shortages.
Keywords

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Volume 1, Issue 2
Autumn 2025
Pages 117-144

  • Receive Date 27 September 2025
  • Revise Date 23 November 2025
  • Accept Date 30 November 2025