Your team got the alert on a Tuesday morning. A critical injectable is on backorder. You've got two days of stock left, maybe three if you stretch it. Now everyone drops what they're doing to call wholesalers, search alternate vendors, rewrite protocols and notify prescribers. Again.
This isn't a one-time fire drill. For most pharmacy teams, it's the rhythm of the job.
Drug shortages have become so persistent, so structural and so damaging that they've quietly redefined what it means to run a pharmacy. But what if the problem isn't the shortages themselves? What if it's the posture pharmacies have been forced into: always reacting, never ready?
Recent headlines suggest the drug shortage crisis may be easing. Don't be fooled.
According to ASHP's latest data, there are currently 216 active drug shortages in the U.S. That's down from the all-time high of 323 in Q1 2024, and new shortages in 2025 hit a 20-year low. But here's what that headline misses: three-quarters of those active shortages began in 2022 or earlier. The backlog isn't clearing. It's just growing more slowly.
And the administrative burden on pharmacy teams hasn't followed the trend line down. ASHP senior director Michael Ganio, PharmD, put it plainly in mid-2025: across all hospital sizes, teams spend an average of 20 hours per week managing shortages. At hospitals with 300 or more beds, that's a full-time job. At the largest hospitals, it's 60 hours a week.
The clinical toll is real. According to Vizient survey data, the share of facilities reporting at least one medication error directly linked to a drug shortage climbed from 38% in 2019 to 43% in 2024. Nearly half of all facilities are drawing a direct line between shortages and patient harm.
The financial toll is severe and still growing. Vizient's 2024 survey found hospital labor costs tied to shortage management reached nearly $900 million annually, up from $359 million in 2019. That's a 150% increase in five years. And the picture could worsen: ASHP has flagged proposed pharmaceutical tariffs as a significant emerging risk, warning that disruptions to active pharmaceutical ingredient supply could create new shortages or deepen existing ones.
The trend may be improving. The underlying vulnerability isn't.
For years, pharmacies have relied on the FDA shortage list and wholesaler alerts to stay informed. Both are valuable. Neither is sufficient.
The fundamental problem: these tools tell you about shortages that have already arrived. By the time a drug appears on an official shortage list, supply has already tightened. Prices have moved. The alternatives your competitors needed are already being scooped up. You're starting from behind.
The FDA's own analysis of drug shortage root causes identifies systemic drivers including manufacturing failures, lack of market incentives for quality systems and supply chain fragility. None of these are expected to resolve on their own. The structural reality is that shortages will keep coming. The reactive model simply can't keep up.
What pharmacy teams need isn't a better alarm. They need a window.
SureCost Drug Shortage Insights™ is built around a four-step framework that moves pharmacy teams from scrambling to planning: Detect, Evaluate, Expand, Execute.
The platform continuously monitors FDA data, wholesaler feeds and SureCost's integrated partner network. It tracks early signals of supply disruption, including slowing fulfillment rates, allocation notices and vendor-level constraints, before they become official shortages.
This changes the entire response posture. When your team sees trouble trending, you're planning. When you find out the day it hits, you're scrambling.
Not every signal is a crisis. Some disruptions resolve in a week. Some will last months. The platform generates risk scores, confidence levels and projected resolution timelines, updated daily, so your team isn't guessing.
A pharmacist seeing that drug X carries a 90% confidence shortage risk expected to last eight more weeks can plan accordingly. A pharmacist seeing that a disruption is likely to resolve in seven days can make a well-reasoned decision not to act. Either way, the decision is built on data, not anxiety.
At a three-week outlook horizon, the platform's predictive accuracy exceeds 95%.
When shortage risk is confirmed, the platform surfaces alternatives automatically: equivalent NDCs using First DataBank data, therapeutic class alternatives when equivalent NDCs aren't available and real-time vendor availability with current pricing.
For multi-site organizations, this intelligence is shared across all locations simultaneously. Every site works from the same sourcing options, eliminating duplication and reducing the cross-site confusion that makes shortages even harder to manage at scale.
With vendor data, baseline pricing and shortage intelligence consolidated in a single workflow, teams can move from identifying a shortage to sourcing a replacement in minutes rather than hours. No toggling between systems. No manual vendor outreach. No gut-check purchasing under pressure.
Hospital and health system pharmacies face some of the most acute risk. Injectable shortages involving anesthetics, chemotherapy and critical IV medications leave little room for on-the-fly substitution. Predictive alerts give hospital teams the lead time they need to plan formulary alternatives, coordinate with clinical staff and maintain compliance readiness.
But the problem spans every care setting.
For LTC pharmacies, residents depend on consistent, uninterrupted therapy across multiple chronic medications. Even short supply disruptions carry serious clinical consequences. Early warnings and rapid equivalence identification allow LTC teams to coordinate substitutions with prescribers proactively, reducing last-minute scrambles and protecting continuity of care.
For community and retail pharmacies, a shortage at the counter risks more than one prescription. It risks the trust a patient has built with their pharmacy over years. The ability to identify alternatives before a patient arrives and communicate a solution rather than an apology is a competitive differentiator that shows up directly in retention.
The ROI of Getting Ahead
Predictive tools are necessary but not sufficient on their own. What separates pharmacies that benefit from shortage intelligence from those that don't is whether the technology is paired with a formal response framework.
Daley's resilience framework, drawn from the National Academies of Sciences, Engineering, and Medicine, organizes shortage response activities around a foundation of communication, analytics and transparency. The key insight is that analytics isn't a support function. It's the base layer on which everything else depends.
In practice, resilient pharmacy teams do a few things in advance:
The goal isn't to eliminate shortages, which would require systemic manufacturing and supply chain reform beyond any single organization's control. The goal is to flatten the curve. To reduce the disruption that any given shortage causes to patients and operations by having a plan already in motion when it arrives.
Drug shortages are not a temporary disruption. The FDA's root cause analysis makes clear that the structural factors driving shortages, including low drug pricing that discourages adequate production, supply chain fragility and quality control challenges, are deeply entrenched. None are expected to diminish in the near term.
The pharmacies that will thrive in this environment aren't the ones that respond faster. They're the ones that see it coming.
Predictive shortage intelligence isn't a feature. It's becoming infrastructure, as foundational to running a modern pharmacy as a dispensing system or an EHR integration. The question pharmacy leaders are starting to ask isn't "should we invest in shortage intelligence?" It's "how much longer can we afford not to?"
The shift from reactive to predictive isn't just an operational upgrade. It's a fundamentally different relationship with the supply chain: one built on foresight, not firefighting.
Ready to see what predictive shortage management looks like for your pharmacy? Read the full SureCost Drug Shortage Insights™ white paper and discover how the Detect, Evaluate, Expand, Execute framework can transform how your team manages supply disruption.