Oncologists are raising alarm over shortages of key generic chemotherapy agents that are forcing substitutions and dose-management strategies in real-world practice. The report cites FDA-listed shortages affecting carboplatin, cisplatin, oxaliplatin, and ifosfamide, with ifosfamide injection formulations estimated to remain in shortage until at least October 2026. Practices are prioritizing treatments with curative intent, looking for alternative regimens when available, and using workarounds such as maximizing doses within available vials. Physicians describe the situation as non-ideal and raise concern that without changes to incentives and pricing, patient access to life-saving options could deteriorate. The article includes commentary from Gury Doshi, MD (Texas Oncology, US Oncology Research), and Michael Reff, RPh (NCODA), underscoring how drug availability is increasingly constraining oncology delivery.