Drug shortages never happen in isolation—they are the product of intricate, interwoven challenges that strain supply chains and leave hospital systems and care centers scrambling for effective solutions. By understanding the root causes, we can better understand these challenges and how we should prepare for them.
1. Manufacturing Disruptions
From quality control failures to production halts, disruptions in manufacturing are one of the leading causes of drug shortages. As the FDA reports, “Manufacturing problems, such as equipment failures or quality control issues, can halt drug production.”[1] The shortage of Cisplatin, a vital chemotherapy agent, became a critical concern in 2023. This shortage was fueled by manufacturing delays, stemming from equipment malfunctions at key production sites, such as manufacturing hubs in North Carolina and Shanghai, and the low profit margins that discourage investment in manufacturing capacity. The impact was significant, with many oncology centers facing delays in treatment schedules, forcing some patients to switch to alternative therapies. These can be less effective, carry greater side effects or provide general disruption to the treatment plan. The ripple effects underscored the fragility of the supply chain for essential but low-margin drugs in 2024. We can’t even begin to predict where the next disruptions will strike, and what type of care they will impact.
2. Increased Demand
Demand surges for certain medications often catch manufacturers off guard, creating sudden and severe shortages. During the pandemic, this dynamic became painfully clear. Amoxicillin, a widely used antibiotic for pediatric bacterial infections, faced significant shortages starting in late 2022 due to a spike in respiratory infections among children and supply chain delays. The Brookings Institution emphasizes the impact: “Limited manufacturing capacity compounds the effects of unexpected spikes in demand.”[2] According to the American Society of Health-System Pharmacists, these shortages often lead to cascading effects in patient care and operational efficiency.[3] For instance, patients may face delays in receiving necessary treatments, resulting in prolonged illnesses or complications. Hospital operations suffer as staff spend increased time sourcing alternatives, and unplanned financial strain arises from higher procurement costs or reliance on gray market suppliers. These cascading effects disrupt the overall workflow and erode both patient trust and organizational stability.
3. Supply Chain Vulnerabilities
The pharmaceutical industry’s reliance on global supply chains leaves it vulnerable to disruptions at every link. Raw material shortages, export bans, and geopolitical instability are among the key vulnerabilities. Specific examples include active pharmaceutical ingredients (APIs) such as heparin, derived from pig intestines, which faced disruptions due to the Russia-Ukraine conflict—a region critical for raw material production. Similarly, trade policy shifts in China limited the export of vital chemical precursors required for contrast media production, like iodine-based compounds. These vulnerabilities illustrate the fragility of global supply chains for essential medications.[1][3] For example, raw materials like active pharmaceutical ingredients (APIs), including heparin used in blood clot prevention, have been significantly affected by the Russia-Ukraine war. This conflict has disrupted European supply chains that rely heavily on pig-derived materials. Additionally, chemical precursors essential for contrast agents, such as iodine-based compounds critical for diagnostic imaging, have been impacted by trade policy shifts in China, which limited exports. These restrictions created bottlenecks in the production of contrast media globally, further exacerbating shortages.[1][3]
One prominent example of these vulnerabilities is the shortage of Omnipaque, a widely used contrast media for imaging. In 2022, global manufacturing shutdowns caused by geopolitical instability and pandemic-related restrictions disrupted its production. The shortage forced healthcare providers to ration imaging procedures, delay diagnoses, and prioritize critical cases. This, in turn, strained hospital resources, increased patient wait times, and compromised timely medical interventions in both emergency and routine care settings. As highlighted by the FDA, “Over-reliance on international suppliers makes the supply chain susceptible to disruptions due to political or environmental factors.”[1]
4. Natural Disasters
Environmental events such as hurricanes can devastate pharmaceutical production hubs, creating immediate shortages. In 2024, Hurricane Helene severely damaged Baxter International’s North Carolina facility, which produces 60% of the IV fluids used in the U.S. healthcare system. This facility’s critical role in supplying hospitals nationwide meant that the disruption led to widespread impacts, including postponed surgeries, delayed patient care, and a scramble among healthcare providers to source alternatives. According to the FDA, “Events like hurricanes can damage manufacturing facilities, leading to sudden shortages.”[1] Beyond IV fluids, the aftermath highlighted vulnerabilities in regional supply chains, as many facilities were unprepared for such large-scale disruptions, further emphasizing the need for proactive planning and diversified sourcing.
This is just a small look at the pharmaceutical shortages that have disrupted our world in the last couple years. With the deep complexities and interwoven causes for shortages, we often have no idea what will come next. The only thing that is certain is that drug shortages will continue, and InformIQ will be there monitoring the impact to the supply chain so you can focus on operations and patient care.
How will you respond? Is your hospital system ready both financially and operationally to meet these coming challenges?
Looking Ahead In the final installment of this series, we’ll explore the practical consequences of these shortages and how proactive solutions can help mitigate their impact.