(NewsNation) — Shortages of cancer drug are causing doctors to make difficult decisions about patient care, including rationing doses and opting for alternate treatment options with more possible side effects.

As of Wednesday, the Food and Drug Administration listed 14 cancer drugs currently in shortage.

“The oncology shortage is especially critical,” FDA Commissioner Dr. Robert Califf told NBC News. “I’m a former intensivist doctor and I’m very aware of the consequences if you can’t get needed chemotherapy.”

As drug shortages reach record levels, thousands of patients are facing delays in receiving treatments for cancer and other life-threatening diseases.

Following a Senate hearing on homeland security in March, the situation is now being framed as a national security threat.

New drug shortages increased by nearly 30% between 2021 and 2022, according to a report prepared for the hearing by the Senate Committee on Homeland Security and Governmental Affairs. By the end of 2022, there was a record five-year high of 295 active drug shortages.

“The ensuing COVID-19 pandemic further exposed longstanding vulnerabilities in the U.S. medical supply chain and the growing threat to the U.S. from an overreliance on China and other countries for manufacturing key drugs, medical supplies, and the raw materials needed to make these products,” the report said.

President Joe Biden’s administration has assembled a team to find long-term solutions for the problems as generic drugmakers, supply chain experts and patient advocates have appeared before lawmakers to discuss the situation.

Beyond supply chain issues, a lack of investment from drug manufacturers could also be contributing to the problem.

“There’s little incentive to invest in generic manufacturing, oftentimes, especially for these much older drugs — the margins aren’t very big,” Michael Ganio, senior director of pharmacy practice and quality at the American Society of Health-System Pharmacists told NBC News. “It’s almost a disincentive.”