Drug Shortages Approach All-Time Record Levels

August 15, 2023

Hospital pharmacists are facing major headwinds obtaining certain medications as drug shortages approach all-time highs, according to a new survey from the American Society of Health-System Pharmacists (ASHP).

The survey, released last week, indicates that 57 percent of hospital and health system pharmacists reported critical shortages for chemotherapy drugs. The survey also indicates significant shortages for steroids, hormonal drugs, amoxicillin, and lidocaine.

Drug shortages have been a discussion point throughout 2023. A U.S. Senate committee report outlined several factors including “economic drivers, insufficient supply chain visibility, and a continued U.S. overreliance on both foreign and geographically concentrated sources for medications.” The report noted the “cascading effects” for patient care, such as care delays, medication errors, and less effective treatments.

"Pharmacists have been managing drug shortages routinely for decades, but we’re now seeing longer, more persistent shortages,” said ASHP Chief Executive Officer Paul W. Abramowitz. “We’re facing shortages for more than 300 drugs, and that trajectory is growing. This reality is unsustainable for hospitals and patients alike.”

Among the key takeaways from the ASHP survey:

• All-time levels:  By the end of the second quarter, there were 309 active shortages, just below the all time high of 320 shortages.
• Changing strategies:  Participants have been deploying several strategies to manage the shortages, including finding alternatives (97%), implementing rationing criteria (85%), and conversion to different dosage forms (84%).
  • On the operational side, hospitals are purchasing other vial sizes (91%), centralizing inventory (83%), and changing products in trays/carts (70%).
• Cost of shortages:  A majority of respondents indicated drug shortages added between 5 percent and 20 percent to their budgets.
• Severity:  About 32 percent of respondents called the state of shortages “critical,” and another 63 percent said they were “moderate.”
• Quotable:  “This issue requires quick action from Congress to address the underlying causes of shortages and ensure patients have the medications they need,” Abramowitz said.

HAP continues to monitor trends in the health care drug supply and provide updates to members. The ASHP survey is available online.