After reaching a record high in 2024, the number of active drug shortages is declining, according to a recent American Society of Health-System Pharmacists report. However, while new shortages have slowed, many hospitals and health systems continue to face challenges managing long-standing supply gaps and rising labor costs alongside persistent shortages in critical medications, like injectables and controlled substances.
“We’re at a point now where I feel comfortable referring to this as a trend,” said Michael Ganio, PharmD, senior director of pharmacy practice and quality at ASHP, citing five quarters of declining active drug shortages.
ASHP estimated the country is on pace to meet a record fewer than 100 drug shortages in 2025, the lowest total since 2006. In the second quarter of 2024 alone, ASHP recorded 300 ongoing drug shortages while the first quarter saw 323 active drug shortages, the highest number since the organization began tracking supply data.
While the number of new shortages declines, many of the older shortages have persisted into mid-2025, affecting hospitals and health systems. Sterile injectables, ADHD medications and controlled substances such as oxycodone and morphine remain difficult to source, Dr. Ganio emphasized. Injectable medications especially are more difficult to produce and substitute with alternatives, which is more challenging for health systems to manage.
“We find that injectable shortages tend to be more challenging to at least to our members and to those that work in any clinics or ambulatory infusion type centers,” Dr. Ganio said. “Also ADHD medications, it’s not easy to switch between those.”
The operational burden of these persistent drug shortages on hospitals and health systems can be significant. A June survey from Vizient estimated that hospital labor costs tied to managing shortages rose from $359 million in 2019 to $894 million in 2024. Aside from labor costs, Vizient also estimated hospitals spend an additional $200 million annually on higher-priced substitutes.
In addition, Dr. Ganio said the persistent drug shortages are an administrative burden on pharmacy staff who spend a large amount of time figuring out alternatives. “On average, across all hospital sizes, it’s about 20 hours a week,” he said, referring to time spent by pharmacy staff to address shortages. “When you hit hospitals that are 300 beds or more, it’s a full 40-hour job for the week, in the largest hospitals it’s 60 hours.”
Looking ahead, ASHP is also closely monitoring potential policy changes, including the proposed 200% pharmaceutical tariff by the Trump administration. Though the tariffs have yet to take effect, Dr. Ganio explained the impact could be difficult to track if manufacturers choose not to explicitly disclose the reasons for discontinuing products.
“If the price is not allowed to rise, there are penalties for some of these drugs if the price rises faster than the rate of inflation and the manufacturer may choose just to stop making the drug,” he said. “But they may never disclose that the reason for discontinuing it is because of tariffs. So, it’s going to be very hard to say tariffs caused X number of discontinuations and shortages.”
