Oxaliplatin is one of the key drugs included in standard treatment protocols for colorectal cancer (CRC). In some regimens, it is prescribed for patients with stage III-IV disease and is considered an essential part of the treatment process. Today, this fundamental drug has almost completely disappeared from pharmacies and hospitals across Ukraine – even despite state funding.

Critical shortage: challenges of 2024–2025

In 2024–2025, medical institutions across the country have faced systemic disruptions in the supply of oxaliplatin. As a result, patients are forced either to wait indefinitely or to purchase the drug out of pocket – a cost that is unaffordable for most.

At present, it is unavailable for purchase even privately. Based on information from Mission Kharkiv beneficiaries – patients, their relatives, and oncology centers – we understand that the problem extends beyond oxaliplatin: access to CRC treatment in Ukraine as a whole is under threat.

While Ukraine struggles to secure basic chemotherapy drugs, CRC patients in the EU and US receive personalized, innovative therapies based on molecular tumor profiling. In Ukraine, such treatment remains the exception rather than the rule.

Innovations that remain out of reach

Examples include medications such as cetuximab and trifluridine/tipiracil, which are part of standard treatment regimens and are widely used in Europe and the US, fully covered by public healthcare programs. In Ukraine, however, they remain unavailable due to their high cost.

These medicines have been recommended for inclusion under Managed Entry Agreements (MEAs) – a mechanism that could make them more accessible. Successful implementation of MEAs could open the door to broader use of these therapies in Ukrainian clinical practice.

Another drug, dostarlimab – approved in the US and EU and showing remarkable results in MSI-H colorectal cancer – is also unavailable for routine clinical use in Ukraine. Some patients can only access such medications through clinical trials or humanitarian aid – and even then, only in rare cases.

Some Ukrainian patients could potentially gain access through participation in clinical trials. However, these opportunities are limited and require stronger state oversight, regulation, and patient rights protection.

In the face of budget constraints and unstable drug supplies, international donors, partner organizations, and charitable foundations play an especially important role in bridging the gap.

Diagnostics as an integral part of treatment

Accurate and timely diagnostics – particularly for CRC – are critical for effective treatment and avoiding unnecessary costs. Yet here, too, Ukraine faces a huge gap.

In the US and EU, molecular testing is a standard practice fully covered by public or insurance programs. It tailors treatment to the tumor’s biological profile, improving the effectiveness of drug selection and preventing waste on ineffective therapies, thus saving public funds. In Ukraine, the cost falls entirely on the patient, and many never even make it to the laboratory after learning the price of the test.

Oxaliplatin is not an innovative luxury – it is a basic necessity

Its shortage in the healthcare system is a warning sign of deeper problems: unstable funding, limited access to diagnostics and innovation, and the absence of an effective national oncology policy.

Ukraine urgently needs systemic change and international support – from ensuring an uninterrupted supply of essential medicines to implementing personalized treatment, expanding clinical research, and introducing managed entry agreements. Without these measures, Ukrainian patients will continue to be left on the sidelines of global medical progress.

‍

‍