Medication shortages affected a record 423 medications by the end of 2024, the highest in a quarter century. These shortages include medications critical to health and safety such as cancer drugs, pain relievers and medicines to treat Attention-Deficit/Hyperactivity disorder.
Drug shortages come with a high financial cost, adding significant pressure to healthcare systems and on patients. They incur about $200 million each year in costs for buying substitute drugs and more than $216 million in the cost of labor to manage shortages. In addition to the direct economic cost, these shortages cause delays in the treatment of patients and worsen health outcomes. it is crucial that health care professionals and patients take whatever steps they can to mitigate the disruptions. This means investigating alternative treatment options as there is little else to be done.
Most Common Causes of Drug Shortages—Known and Unknown
Medication shortages are a complex problem with multiple causes. But the largest contributor is unknown—55%–making its solution currently out of reach. Manufacturing complications are the largest known factor—23%– and it includes loss of quality control, failed logistics and problems that slow down production or stop it altogether such as contamination or equipment failure.
Nearly 80 percent of raw materials are obtained from abroad (e.g., Europe, India, and China) and these are vulnerable to international economic and geopolitical pressures. But shortages of raw materials, crucial for drug manufacture, make the situation only a little worse, as this factor only contributes 3%. Changes in international trade agreements will not have that much of an effect on the problem.
Supply and demand imbalances play another important, if modest role in shortages, usually limited to specific drugs in high demand. The best example is the shortage, lasting from 2022 to mid 2025 of brand name GLP-1 medications for weight loss and for metabolic illnesses such as diabetes. These include Ozempic and Wegovy (semaglutide) and Mounjaro and Zepbound (tirzepatide). The pharmaceutical companies responsible for these medications simply under-estimated how effective and popular they would be.
Demand rises to outstrip supply in unanticipated emergencies or increased awareness of public health. During the COVID-19 pandemic, for instance, the demand for certain medications exploded, straining an already stretched supply chain even further. Additionally, changes in regulations, which are meant to increase safety and efficacy, can end up curtailing the approval process for new batches of drugs or generics, and especially, drugs with low margin, like some cancer treatments.
One may only speculate as to what is included in the “unknown” category. The shortage of stimulants to treat ADHD—very widespread and persistent—might be due to the explosion during the pandemic of fly-by-night online/telehealth businesses set up not to provide comprehensive and high-quality mental health care, but to prescribe stimulants and nothing else.
What To Do About Drug Shortages
A shortage of your medication is stressful, but there are several proactive measures you can take to minimize the disruption. For medications that are frequently hard to find, take these steps.
- Prepare in advance by calling your insurance company to find out which other similar medications are covered.
- Before requesting refills, contact your pharmacy to determine the availability of your prescribed medication.
- If your medicine is not in stock, ask the pharmacist if they have the same medication in different dosages that might be combined or split.
- Also ask what comparable medications they do have on hand and in what dosages.
- Leave a message for your doctor (by name) using the Sterling Institute refill line. Explain the problem and the solution.
- If that fails, use online tools such as https://www.google.com/maps to locate other pharmacies near you and call to ask them the same questions about what is available.
- Be sure to check with smaller, family-owned pharmacies as well. They will often go the extra mile to obtain your medication for you.
- If a medication needs to be substituted, check with your insurance company to find out which alternatives they cover and at what tier.
- Alternately, you may enter into a search engine the name of your insurance company, the type of plan it is, the medication you are inquiring about and the phrase “pdf formulary.” For example, if you enter “blue cross blue shield silver plan pdf 2025 formulary” into Google, you will find a link for https://www.anthem.com/ct/pharmacy-information/drug-list-formulary where you will be able to look up your covered medications by yourself
- You may also want to check the website https://www.goodrx.com/ . Here you can find often steeply discounted coupons for your medication along with the resulting out of pocket price at various pharmacies (the prices are usually wildly different at different places).
- If you want your Sterling Institute doctor to send a medication using goodrx.com and/or to a different pharmacy for any reason, make sure you say so in your message.
Besides local pharmacies, check mail-order pharmacies and home delivery services, which are typically covered under health insurance.
And of course…
Talk to Your Doctor about Alternatives
Your doctor can apprise you of different dosages and formulations (the same molecule with a different delivery system).
Also, do note that stopping medication on your own prematurely is not advisable. Abruptly stopping medication can cause negative side effects that could worsen your condition or trigger withdrawal. Reading your body well and keeping an ongoing dialogue with your physician is the best way to make changes to your medication plan, and to ensure that you can do so as safely and effectively as possible.
Identifying Other Potential Solutions and Resources
For those struggling with medication shortages, the FDA’s Drug Shortage Database https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages is an important tool as it provides the latest information on current and resolved shortages and possible alternatives. Contacting a drug manufacturer directly may offer further information as to why an individual medication is experiencing a shortage and what is being done to mitigate it. Again, understanding the underlying factors can help patients collaborate more purposefully with medical professionals in navigating their care plans.
Another important factor in medicating up the family during a drug shortage is knowing what your insurance policy states about refills and alternatives to the medications the family typically takes. Understanding these policies assists patients in making informed choices regarding their healthcare options and guarantees continuity in care. This open and supportive attitude is well expressed through integrated care approaches at Sterling Institute, where the focus is on patient centered support and best outcomes in terms of mental health. Their full spectrum of services including psychiatry and advanced care with new treatments, such as trans-cranial magnetic stimulation, reflects the varied needs of patients. For more information on managing medication shortages and holistic mental health services, visit https://sterlinginstitute.org/
Challenges In Getting Your Medication
Monitoring of drug shortages essential for maintenance of care. Staying informed about the availability of pharmaceuticals allows patients to better manage their prescriptions and minimize the effects when drugs are in short supply. To stay informed about current shortages and potential alternatives, check the FDA’s Drug Shortage Database regularly, or consult with pharmacists. Also an independent or lesser known chain pharmacy may have a supply of medications that may be in short supply at other pharmacies. Keeping in contact with healthcare providers and pharmacists can help patients navigate around potential shortages to help keep their treatment plan uninterrupted.
Integrated care solutions can provide a holistic mechanism to prevent, mitigate, or respond to medication shortages and their impact. A few examples of such institutions that focus primarily on organizing care around the patient are the Sterling Institute. During periods of medication shortage, this can lead to more time in relationships over symbioses. They offer a broad variety of services, including pharmacology consultations, to help patients manage drug shortages while not compromising their mental health treatment plans. The Sterling Institute also provides a variety of mental health services to help patients cope with stress and anxiety due to medication availability across the board. If you wish to learn more about these services, how they can help during a drug shortage, and about the Sterling Institute, please follow this link. For more information about these options, go here: Sterling Institute.
