Flood-Damaged Plant May Prolong US Chemotherapy Shortages to 2028

A Pfizer joint-venture facility in India that manufactures injectable chemotherapy agents for patients in the US remains closed following severe flooding in July 2026, and new supplies from the site are not expected to become available until mid-to-late 2028 under the company’s best-case estimate, according to a report from Fierce Pharma.¹

The Zydus Hospira Oncology Private Limited manufacturing facility in Ahmedabad, Gujarat, was severely flooded by heavy monsoon rains on July 23, 2026, a Pfizer spokesperson said in an emailed statement. The plant is a joint venture between Pfizer and Zydus Cadila. The closure was first reported by Endpoints and later confirmed by Pfizer.

According to Pfizer’s website, the facility has an annual production capacity of 7 million vials and supplies markets in the US, Europe, Australia, New Zealand, Japan, Canada, and the Asia-Pacific region.

The prolonged closure is already affecting supplies of certain Pfizer chemotherapy products. The American Society of Health-System Pharmacists (ASHP) drug shortage database has identified manufacturing delays related to the flooding as a cause of shortages of cytarabine, irinotecan, and bleomycin injections.

The extended shutdown threatens to compound existing shortages of chemotherapy drugs in the US, according to ASHP’s latest national drug shortages report, which includes data through the third quarter of 2026. The report noted that chemotherapy shortages remain problematic, with multiple agents in short supply, and that a key supplier affected by flooding in India will not reopen until 2028.²

Across all drug classes, ASHP counted 87 new shortages in 2026 as of the end of the third quarter, nearly matching the total of 89 recorded for all of 2025. The number of active shortages stood at 225, like the previous 3 quarters but well below the all-time high of 323 recorded in the first quarter of 2024. The report cautioned, however, that lower shortage counts do not necessarily mean fewer patients are affected, because a single shortage can have an impact on large numbers of patients.

Several other trends in the report carry implications for oncology practices. Controlled substances account for 16% of active drug shortages, and ASHP warned that patients with chronic pain or attention-deficit/hyperactivity disorder may be unable to fill monthly prescriptions, while health systems may have difficulty obtaining sufficient supplies for surgeries and procedures. Contrast agents used in potentially lifesaving procedures such as CT and MRI represent 10% of all new shortages reported in 2026.

ASHP also highlighted that shortages driven by increased demand, such as those affecting estradiol transdermal patches, can leave patients without treatment. The effect of the conflict in Iran on the US drug supply remains unclear, according to the report.

Beyond direct patient impact, the report pointed to the operational burden of managing shortages. The work required to respond to them, including changes to pharmacy automation systems and electronic health records, adds to the challenges posed by ongoing pharmacy staffing shortages.²

Pfizer is looking to reroute supply while the Gujarat plant remains offline, according to Fierce Pharma. Elsewhere in India, the company operates a manufacturing facility in Goa that primarily produces small-molecule drugs and oral solids, as well as a sterile injectables plant in Visakhapatnam, Andhra Pradesh, that employs roughly 2000 people.

The ASHP report’s data are provided by the University of Utah Drug Information Service, which maintains a national drug shortage database with ASHP that tracks drug availability across the country. The report also points clinicians and health-system leaders to policy resources, including ASHP’s policy solutions to address the drug shortage crisis and the Clinical Resources for Emergency Shortages of Treatments and Supplies program.

References

1. Pfizer looks to reroute supply after flooding sidelined India injectables plant. Fierce Pharma. Accessed November 2, 2026. https://tinyurl.com/mcp22p4n
2. National drug shortages: January 2001 – September 2026. American Society of Health-System Pharmacists. Accessed November 2, 2026. https://tinyurl.com/yxcsuysh