As of December 2025, over 270 drugs remain in short supply across the United States - a number that’s barely improved since last year, despite repeated promises from regulators and manufacturers. For patients, this isn’t just an inconvenience. It’s a life-or-death reality. If you’re on chemotherapy, need IV fluids after surgery, or rely on ADHD medication, you might already be feeling the impact. And it’s getting worse, not better.
What’s Actually Running Out?
The most critical shortages aren’t obscure generics. They’re the backbone of modern care. Here’s what’s in short supply right now:- 5% Dextrose Injection (small bags) - Used for hydration, delivering medications, and treating low blood sugar. Shortage began in February 2022. Expected to last until August 2025.
- 50% Dextrose Injection - Critical for emergency hypoglycemia. Shortage since December 2021. Resolution expected September 2025.
- Cisplatin - A key chemotherapy drug for testicular, ovarian, and lung cancers. A 2022 quality failure at an Indian manufacturing plant cut supply by half. Hospitals are rationing it, prioritizing patients with the highest survival rates.
- Vancomycin - One of the last-resort antibiotics for MRSA and other resistant infections. Shortages have spiked since early 2024 due to production delays.
- Levothyroxine - The most prescribed thyroid medication in the U.S. Demand has surged 22% since 2022, outpacing supply. Patients are being switched to less reliable alternatives.
- GLP-1 agonists (e.g., semaglutide, tirzepatide) - Used for diabetes and weight loss. Demand has grown 35% annually since 2020. Manufacturers can’t keep up, and pharmacies are limiting prescriptions to 30-day supplies.
These aren’t random glitches. They’re systemic failures. The same few factories - mostly in India and China - produce the majority of these drugs. When one facility fails an FDA inspection, the entire U.S. supply can freeze.
Why This Keeps Happening
You might think drug shortages are caused by pandemics or natural disasters. They’re not. The real reasons are simpler - and more preventable.- Low profit margins - Generic drugs make up 90% of prescriptions but only 20% of pharmaceutical revenue. Manufacturers make 5-8% profit on them. Compare that to brand-name drugs, which earn 30-40%. Why would a company invest in expanding production for a drug that barely pays?
- Overseas dependency - 60% of active pharmaceutical ingredients (APIs) come from India and China. A single quality control failure at an Indian plant can wipe out half the U.S. supply of cisplatin. A trade dispute or shipping delay can starve hospitals of vancomycin.
- Outdated regulations - The FDA can’t force a company to make more of a drug, even when it’s life-saving. They can only wait for manufacturers to report problems - and many delay reporting to avoid scrutiny.
- Demand spikes - When a new weight-loss drug becomes popular, demand doesn’t just rise. It explodes. Manufacturers didn’t plan for this. They assumed steady, predictable sales. Now they’re scrambling.
It’s not a supply chain issue. It’s a profit issue. If making a drug doesn’t pay enough, companies won’t make it - no matter how many people need it.
Who’s Getting Hurt?
This isn’t abstract. Real people are skipping treatments, delaying surgeries, or getting sicker because of these shortages.- 31% of cancer patients reported treatment delays in 2024, with an average wait of nearly 15 days per interruption.
- 78% of doctors say they’ve had to postpone care because a drug wasn’t available.
- 43% of physicians have had to prescribe less effective or riskier alternatives.
- 92% of hospital pharmacists spend over 10 hours a week just managing shortages - time they could be spending with patients.
- 67% of pharmacists report medication errors directly tied to substitutions - like giving the wrong dose or wrong drug because the original wasn’t available.
One pharmacist in Ohio told Reddit how they had to ration cisplatin: only patients with testicular cancer - where it’s most effective - got it. Others were put on older, more toxic drugs. That’s not medicine. That’s triage.
What’s Being Done?
There are some efforts to fix this - but they’re too slow, too weak, and too late.- The FDA launched a new reporting portal in January 2025. It’s received over 1,200 reports in three months - and acted on 87% of them. But it’s still reactive. It doesn’t stop shortages. It just responds to them.
- 47 states now let pharmacists substitute similar drugs during shortages. But only 19 let them do it without calling a doctor first. That delays care.
- New York is testing an online public database that shows which pharmacies still have drugs in stock. Hawaii now allows imported drugs approved in other countries - a smart move, since many are just as safe.
- The Drug Shortage Prevention Act requires manufacturers to report disruptions earlier. But enforcement is weak. Many still wait until it’s too late.
Meanwhile, the Congressional Budget Office warns: if proposed tariffs on Chinese and Indian pharmaceuticals go through, shortages could jump to 350+ by 2026. That’s not a prediction. It’s a countdown.
What Can You Do?
If you’re a patient, here’s what you can do right now:- Ask your doctor or pharmacist - Is your medication on the shortage list? Are there alternatives? Don’t assume your prescription is safe.
- Check the ASHP Drug Shortages Database - It’s free, updated daily, and lists every drug in short supply with expected resolution dates.
- Don’t hoard - Stockpiling creates artificial shortages. It hurts others who need it more.
- Report a shortage - If your pharmacy runs out and it’s not listed online, report it to the FDA’s new portal. Your report could trigger action.
- Ask about generic alternatives - Sometimes, a different generic brand is available. Not all generics are made in the same factory.
If you’re a healthcare provider, start building a 30-day backup inventory for your top 10 most critical drugs. Most hospitals don’t. They’re flying blind. And if you’re a policymaker? Demand real change: financial incentives for domestic manufacturing, mandatory stockpiles, and a national early warning system that actually works.
What’s Next?
The problem isn’t going away. Even if every shortage resolved tomorrow, the system that caused it is still broken. Without major policy shifts - and real investment in domestic production - we’ll be back here next year. And the year after that.Medications aren’t commodities. They’re lifelines. And right now, too many of them are running out.
What are the most common drugs in short supply right now?
As of December 2025, the most common shortages include 5% and 50% Dextrose injections, cisplatin (a chemotherapy drug), vancomycin (an antibiotic), levothyroxine (for thyroid conditions), and GLP-1 agonists like semaglutide. These are used in emergency care, cancer treatment, infection control, and chronic disease management. The shortages are driven by manufacturing issues, high demand, and global supply chain vulnerabilities.
Why are generic drugs more likely to be in short supply than brand-name drugs?
Generic drugs make up 90% of prescriptions but only 20% of pharmaceutical revenue. Manufacturers earn only 5-8% profit on them, compared to 30-40% for brand-name drugs. With such thin margins, companies have little incentive to invest in production capacity or quality upgrades. When a factory shuts down for inspection, there’s often no backup supplier - because no one else made a profit from making the same drug.
Can I get my medication from another country if it’s unavailable in the U.S.?
Legally, importing medications from other countries is restricted in the U.S. - but exceptions exist. Hawaii’s Medicaid program now allows foreign-approved versions of certain drugs during shortages. Some patients have successfully obtained medications from Canada or the EU through licensed pharmacies. However, this isn’t a widespread solution. Always consult your doctor before switching sources. Safety and quality control vary by country.
Are drug shortages getting worse or better?
The number of active shortages has dropped slightly - from 323 in early 2024 to 270 in early 2025 - but the underlying causes haven’t improved. Most current shortages began in 2022 or earlier and remain unresolved. New shortages are still emerging, especially in ADHD and weight-loss medications. Without structural reforms, experts predict shortages will stay above 250 through 2027, with possible spikes if tariffs on Chinese and Indian pharmaceuticals are imposed.
How do hospitals manage drug shortages?
Hospitals use several strategies: rationing critical drugs (like cisplatin) to patients with the highest survival benefit, switching to therapeutically equivalent alternatives, using oral instead of IV fluids when possible, and conducting daily inventory checks. Many have also created emergency stockpiles of 30 days’ worth of top drugs - but only 28% of hospitals can afford to do this. Pharmacists spend over 10 hours a week just tracking and managing shortages, often leading to errors and burnout.
Is there a national system to track drug shortages in real time?
The American Society of Health-System Pharmacists (ASHP) maintains the most comprehensive public database, updated daily. The FDA also has a new reporting portal where providers can submit unlisted shortages - over 1,200 reports have been submitted since January 2025. However, there’s no real-time national dashboard that pulls data from manufacturers, distributors, and pharmacies together. A unified early warning system is still just a proposal.
