The supply of cisplatin, a platinum-based chemotherapy drug used to treat various cancers, has been cut off at the BP Koirala Memorial Cancer Hospital in Chitwan for three months.

Similarly, the hospital also ran out of another platinum-based chemotherapy drug, carboplatin, last week.

‘We do not have both drugs, nor have we been able to get them from the market,’ said Dr. Umesh Nepal, the hospital’s acting director. ‘Patients with various types of cancer and their relatives are in serious trouble due to the acute shortage of the drug.’

Along with carboplatin and cisplatin, oxaliplatin is also a drug used in chemotherapy for cancer patients. Doctors say there is an acute shortage of all three drugs in Nepal.

According to doctors, carboplatin, cisplatin and oxaliplatin are platinum-based chemotherapy drugs, which are used to treat various solid tumors, including ovarian, lung, head, neck and breast cancer. These drugs affect the DNA of cancer cells and stop their growth.

Oxaliplatin is mainly used to treat advanced colorectal cancer.

These drugs should be given in combination with other drugs. Doctors have warned that the effectiveness of the treatment will decrease if these drugs are not included in the treatment.

After all efforts to provide the drugs failed, the hospital on Friday requested an emergency supply from the World Health Organization (WHO) Nepal office.

“We had to send a formal letter to the UN health agency today,” Dr. Nepal said, “If we get the drugs from WHO, the problems of patients and their relatives will be reduced.”

Every day, 150 to 200 cancer patients of various organs reach BP Koirala Memorial Cancer Hospital for chemotherapy. According to doctors, these drugs are necessary in almost all types of cancer treatment.

According to cancer experts, carboplatin, cisplatin and oxaliplatin are effective drugs widely used in the treatment of curable cancers.

Dr. Sandhya Chapagain, a senior cancer specialist at Bir Hospital, says the price hike is due to the increase in the cost of ingredients used to make medicines. “The price of raw materials, including silver, used to make medicines has increased manifold,” she said. “That is why suppliers have not been able to import medicines and there is a shortage. The government must solve the problem immediately.”

Other cancer specialists have also complained about the lack of cheap and effective medicines. “Patients and their relatives are forced to go to India to buy medicines,” said Dr. Sudeep Shrestha, chairman of Nepal Cancer Hospital in Lalitpur. “These medicines are effective and widely used in almost all types of cancer treatment. Prolonged shortages affect treatment.”

According to drug suppliers, the supply has been stopped due to the high price due to the strengthening of the US dollar and the cost of raw materials.

‘We have not imported for three months as we did not get permission to increase the price fixed a decade ago,’ said Madhu Chitrakar, an official at Prime Life Care, a company that imports carboplatin from Bangladesh. ‘Drug manufacturing companies have increased the price by two to three times the price fixed by the Department of Medicines.’

Both carboplatin and cisplatin are injectable drugs, which are considered cheaper and more effective than other drugs. According to suppliers, the Department of Medicines has fixed the price of 100 mg of the drug at Rs 1,300 and Rs 4,350 for 450 mg. But its price in the international market has increased by two to three times.

‘The price of raw materials has increased drastically due to the appreciation of the US dollar and the war in West Asia,’ said Deepak Tibrewal, director of DKM Pharmaceuticals. ‘We cannot sell the drug at a price below cost.’

Suppliers have complained that the government adjusts the price of petroleum products every 15 days but has not reviewed the prices of 96 drugs on the essential medicines list for 11 years.

Meanwhile, the Nepal branch of the South Asian Association for Regional Cooperation (SAARC) Cancer Specialists' Association has expressed deep concern over the increasing difficulty in supplying and accessing essential platinum-based chemotherapy drugs in Nepal.

In a letter sent to the drug regulatory body, the federation has warned that disruption or delay in the supply of these drugs will directly affect the lives of patients and treatment outcomes.

Meanwhile, the Department of Drug Management, the national drug market regulator, said that it has agreed with the supplier representatives in a meeting held at the Ministry of Health on Friday to resume the supply of the drugs immediately.