As we start a new year, it’s the perfect moment to reflect on the hurdles we’ve overcome and the insights we’ve gained. How has your hospital system navigated the ongoing struggle of drug shortages?

• Delayed treatments?

• Transferred patients?

• Fought with P&T committees?

• Received push back from payers on higher cost alternates?

• Scrambled into the Grey market?

It’s been a year full of hurdles, but also lessons—and there’s value in looking back to prepare for what’s ahead. Drug shortages are an ever-present challenge, disrupting care delivery, delaying vital treatments, and placing significant strain on healthcare providers who must navigate these unpredictable obstacles. Which drugs will experience a shortage next? It’s the question every hospital system dreads. 

The phenomenon of drug shortages is entirely predictable—a consistent, growing challenge that continues to disrupt care delivery and operational efficiency across healthcare. In 2024, some of the most disruptive shortages included Amoxicillin, which saw a significant rise in demand due to pediatric respiratory infections, and IV fluids, whose supply was heavily impacted by Hurricane Helene’s damage to Baxter International’s North Carolina facility.[1][3] These examples highlight the persistent vulnerabilities in the pharmaceutical supply chain and underscore the need for proactive solutions.

The Predictable Nature of Drug Shortages 

While we can’t always predict which drugs will fall into shortage, the underlying trends remain consistent. Drug shortages are driven by systemic issues that recur year after year, creating ripples across hospital systems and patient care. These systemic disruptions stem from a range of vulnerabilities, including manufacturing delays, economic disincentives, surges in demand, supply chain fragility, and environment events like hurricanes.

Manufacturing delays often arise from equipment failures like aging or malfunctioning machinery that leads to slowed production, and quality control issues. This can result in entire batches being scrapped when they fail to meet regulatory standards. Low profit margins and race to the bottom pricing for certain essential drugs have discouraged manufacturers from expanding or upgrading production capacity. This combination of factors creates a fragile system where even minor disruptions can cascade into widespread shortages, leaving healthcare providers without critical medications for patient care.

Surges in demand can be triggered by unexpected spikes in illness. Supply chain fragility is compounded by reliance on global suppliers for raw materials which are vulnerable to geopolitical tensions such as global trade policy shifts. The current news cycle gives us plenty of reasons to be ready for a few more trade policy related disruptions in the coming years. 

Environmental events, like the hurricanes we experienced this year in the southeast showcase the interconnected vulnerabilities of the pharmaceutical supply chain.[1][2][3]

This glimpse into recent pharmaceutical shortages offers just a fraction of the larger picture. The deep complexities and interconnected causes make it nearly impossible to predict exactly what will come next. However, one thing remains certain: Drug shortages are not going away. The question then becomes: How will your hospital system prepare? Are you equipped—financially, operationally, and strategically—to navigate these ongoing challenges and ensure seamless patient care in the face of uncertainty?

Looking Ahead 

In the next installment, we’ll delve into the four primary factors that drive shortages and spotlight examples of how these factors have played out over the past year. Understanding these causes is the first step toward proactive preparation.

Wishing you all a Happy, Healthy, Prosperous 2025!

Kenny

Explore Our Sources:

[1] U.S. Food and Drug Administration. “Report | Drug Shortages: Root Causes and Potential Solutions.”
https://www.fda.gov/drugs/drug-shortages/report-drug-shortages-root-causes-and-potential-solutions

[2] Brookings Institution. “Drug shortages: A guide to policy solutions.” March 13, 2024 https://www.brookings.edu/articles/drug-shortages 

[3] American Society of Health-System Pharmacists. “ASHP Guidelines on Managing Drug Product Shortages”
https://www.ashp.org/-/media/assets/policy-guidelines/docs/guidelines/managing-drug-product-shortages.ashx