As of December 2025, over 270 medications are still in short supply across the United States - a number that may seem lower than last year’s peak, but still represents a dangerous level of instability in the healthcare system. For patients relying on these drugs, the impact isn’t theoretical. It’s real. It’s delaying cancer treatments. It’s forcing hospitals to ration saline bags. It’s making everyday prescriptions harder to fill - even when you’ve paid for them.
What’s Actually in Short Supply Right Now?
The most critical shortages aren’t random. They cluster in specific drug classes that are essential, hard to make, and low-profit. The top categories still struggling include:- Sterile injectables: These are the backbone of hospital care. Drugs like 5% Dextrose Injection (in small bags) and 50% Dextrose Injection remain scarce, with no resolution expected until late summer or early fall 2025. These are used for dehydration, low blood sugar, and IV nutrition.
- Chemotherapy drugs: Cisplatin, carboplatin, and doxorubicin are still in limited supply. A 2022 quality control failure at a major Indian manufacturing plant cut off half the U.S. supply of cisplatin - a drug critical for treating testicular, ovarian, and lung cancers. Hospitals now ration it, prioritizing patients with the highest survival chances.
- Intravenous fluids: Normal saline (0.9% sodium chloride) and lactated Ringer’s solutions are still tight. While not completely gone, many hospitals have cut back on routine use, encouraging oral rehydration when possible.
- ADHD medications: Methylphenidate (Ritalin, Concerta) and amphetamine formulations (Adderall) are still hard to find. Demand has grown 35% annually since 2020, outpacing manufacturing capacity.
- GLP-1 weight loss drugs: Semaglutide (Wegovy, Ozempic) and liraglutide (Saxenda) are experiencing new waves of shortages. These aren’t just for obesity - they’re used off-label for diabetes and metabolic conditions, stretching supply thin.
- Antibiotics: Vancomycin, cefazolin, and piperacillin-tazobactam are still in short supply, especially in pediatric and ICU settings.
What’s surprising? Brand-name drugs like insulin or blood pressure medications are rarely affected. The problem isn’t about popularity - it’s about profit.
Why Are These Drugs So Hard to Make?
It’s not a simple case of “not enough factories.” The issue is structural.Over 80% of the active ingredients in U.S. medications come from just two countries: India (45%) and China (25%). These aren’t just pills - they’re complex chemical compounds made in multi-step processes that require extreme precision. A single failed batch can shut down production for months.
For example, cisplatin requires ultra-pure platinum compounds and sterile filling lines. One FDA inspection in 2022 found mold in a clean room at an Indian plant. That one issue knocked out half the U.S. supply. And because these drugs are generics, manufacturers make only 5-8% profit per unit. Why invest millions to upgrade equipment when you can make more money selling something else?
Meanwhile, demand keeps rising. GLP-1 drugs? 3 million Americans are now on them. ADHD prescriptions? Up 40% since 2020. Hospitals need more IV fluids because of heatwaves and longer ER stays. But production hasn’t kept up.
Who’s Feeling the Impact?
It’s not just patients. Healthcare workers are drowning in the fallout.- 92% of hospital pharmacists spend over 10 hours a week just tracking down drugs or finding alternatives.
- 67% report medication errors caused by last-minute substitutions - like switching from a branded chemo drug to a generic with different dosing.
- 78% of doctors say they’ve delayed treatments because a drug wasn’t available.
- 31% of cancer patients experienced treatment interruptions in 2024, with delays averaging nearly two weeks.
One Ohio pharmacist described rationing cisplatin by cancer type - giving it only to patients with testicular cancer, where survival rates jump from 50% to over 90% with the drug. Other patients got less effective alternatives. That’s not a medical decision. That’s a supply chain failure.
Why Can’t We Just Make More?
The FDA says it stops about 200 potential shortages every year by nudging manufacturers to fix problems or ramp up production. But here’s the catch: they can’t force anyone to do it.There’s no law requiring companies to maintain minimum stockpiles. No penalty for stopping production of a critical drug. No requirement to tell the FDA when they’re running low on raw materials from overseas.
Proposed tariffs of 50-200% on Chinese and Indian pharmaceutical ingredients could make things worse. If a bag of saline costs $1.50 to make now, a 100% tariff could push it to $3.00 - and manufacturers might just stop making it entirely.
Some states are trying to fix this. New York is building an online database so doctors and pharmacists can see which pharmacies still have saline or insulin in stock. Hawaii now allows Medicaid to pay for drugs approved in Canada or the EU during shortages. But these are patches - not solutions.
What Can You Do If Your Drug Is in Shortage?
If you’re on a medication that’s hard to find, here’s what actually works:- Call your pharmacy early. Don’t wait until your prescription runs out. Ask if they have it in stock or when it’s expected.
- Ask about alternatives. Many shortages involve generics. Your doctor may be able to switch you to a therapeutically equivalent drug. For example, if cisplatin isn’t available, carboplatin might work - though it’s not always as effective.
- Check the ASHP Drug Shortages Database. It’s updated weekly and lists expected resolution dates. You can search by drug name or category.
- Don’t skip doses. If you can’t get your medication, call your doctor. Stopping chemotherapy or insulin without guidance can be dangerous.
- Use patient advocacy groups. Organizations like Patients for Affordable Drugs can help connect you with resources or clinical trial access if your treatment is delayed.
Pharmacists in 47 states can now substitute certain drugs without a new prescription - but only if they’re proven to be equally safe and effective. Ask if that’s an option for you.
What’s Changing in 2025?
There’s some progress - but not enough.- The FDA launched a new public reporting portal in January 2025. Over 1,200 shortages were reported by providers in the first three months - 87% led to FDA intervention.
- 63 shortages were resolved in Q1 2025, mostly antibiotics. That’s a win - but 40% of current shortages started in 2022 or earlier.
- More hospitals are starting to keep 30-day stockpiles of critical drugs. But only 28% can afford it.
The big picture? Without major policy changes - like tax breaks for U.S.-based API manufacturing, mandatory stockpiles, or penalties for supply chain neglect - shortages will stay above 250 through 2027. If tariffs hit, we could see over 350 active shortages by next year.
This isn’t a glitch. It’s a system failure. And until the financial incentives change, the same drugs will keep disappearing - while patients and providers scramble to keep up.
What drugs are currently in the worst shortage in 2025?
The most critical shortages in late 2025 include sterile IV fluids like 5% and 50% Dextrose, chemotherapy drugs such as cisplatin and doxorubicin, ADHD medications like methylphenidate and amphetamines, and GLP-1 weight loss drugs like semaglutide. These are not rare drugs - they’re used daily in hospitals, clinics, and homes across the country.
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 just 5-8% profit per unit, while brand-name drugs can earn 30-40%. With such thin margins, companies don’t invest in upgrading equipment or keeping backup supplies. If one factory has a problem, there’s often no backup - and no financial reason to fix it quickly.
Can I get my medicine from another country if it’s out of stock in the U.S.?
In most cases, no - U.S. law bans importing prescription drugs from abroad. But Hawaii’s Medicaid program now allows foreign-approved versions of certain drugs during shortages. Other states are considering similar policies. For now, talk to your doctor about FDA-approved alternatives instead.
How long do drug shortages usually last?
It varies. Some resolve in weeks; others last years. The average shortage now lasts over 18 months. Many of the current ones started in 2022 or earlier and haven’t been fully resolved. The FDA estimates resolution times improved by 15% since 2023, but only because they’re intervening more - not because the system is fixed.
Is there a way to know if my pharmacy has the drug I need?
Yes. Use the ASHP Drug Shortages Database to check the status of your medication. Then call your pharmacy directly - don’t rely on online inventory tools. Some pharmacies get allocations in batches and may have stock even if the system says they’re out. In New York, a new public database will soon show which pharmacies have specific drugs in stock.
Just got off the phone with my oncologist-cisplatin’s still not in stock. We’re switching to carboplatin, but it’s not the same. I’ve been on this treatment for 18 months and now I’m back to playing drug roulette. It’s exhausting. I just want to know I’m getting the best shot at survival, not whatever’s left on the shelf.
My pharmacist said they got a tiny shipment last week, but it was all spoken for before noon. We’re all just waiting for the next batch like it’s a concert ticket.
I cried in the pharmacy aisle yesterday because they didn’t have my Adderall. Again. I’m not even asking for the brand-I just need *something* that works. I’ve been late to work three times this week because I can’t focus. And now they’re telling me to ‘try behavioral therapy’ like that’s gonna fix my brain chemistry.
Why is my mental health less important than someone’s trendy weight loss drug?
The structural inefficiencies in the U.S. pharmaceutical supply chain are a textbook case of market failure driven by rent-seeking behavior and regulatory capture. The absence of mandatory inventory thresholds, coupled with the commoditization of generic drugs, incentivizes manufacturers to externalize risk while internalizing profit.
Furthermore, the FDA’s reactive-not proactive-model of intervention reveals a fundamental epistemological flaw in public health governance: we treat shortages as anomalies rather than systemic outcomes of deregulated capitalism. The fact that 80% of APIs originate in two geopolitical regions with opaque regulatory environments is not a coincidence-it’s a strategic vulnerability engineered by decades of offshoring driven by shareholder value maximization.
Until we treat pharmaceuticals as public goods-not profit vehicles-this will persist. And yes, tariffs will make it worse. But the root cause is not China or India. It’s Wall Street.
You’re not alone. I’ve been there. Keep pushing your doc for alternatives. And call pharmacies early-sometimes they get stock after hours. You’ve got this.
Let’s be real-this isn’t just about drug manufacturing. It’s about how we’ve turned healthcare into a transactional service instead of a human right. We’ve got billionaires buying private islands while people are skipping insulin doses because they can’t afford the $400 copay even when the drug is available.
And don’t get me started on GLP-1 drugs. People are getting them for weight loss while cancer patients wait months for chemo. The moral inversion here is staggering. We reward vanity and punish survival. The system isn’t broken-it’s working exactly as designed.
I’ve worked in hospital pharmacy for 22 years. I’ve seen this cycle repeat since 2008. Nothing changes. Nothing ever changes.
And now we’re talking about tariffs? That’s like putting a bandaid on a severed artery. We need national drug production mandates, public manufacturing hubs, and real penalties for companies that let critical drugs disappear. Otherwise, we’re just rearranging deck chairs on the Titanic.
Yo, I’m a pharmacist in Chicago and I see this daily. Here’s the real tea: most shortages aren’t about ‘not enough supply’-they’re about ‘no one wants to make it.’
Think about it: a 500ml bag of saline costs $1.20 to make and sells for $3.50. But to make it? You need a clean room, sterile techs, QA checks, FDA audits, and a team of engineers. Meanwhile, a guy in a garage can make a $100K/month side hustle selling NFTs.
So why would any sane person invest $20M in a sterile line when they can build a TikTok app?
And don’t even get me started on the Indian factories. One mold spore shuts down half the country’s cisplatin. One. Spore.
Meanwhile, the FDA’s got 30 inspectors for 1000+ foreign plants. It’s like sending one cop to guard the entire Amazon warehouse.
But hey-here’s a silver lining: more hospitals are finally stockpiling. And some states are letting in Canadian meds. Small wins. Keep pushing. 🙌
It’s fascinating how society has normalized pharmaceutical scarcity as an inevitable consequence of modernity. We accept that our lives are contingent on the profit margins of multinational corporations with no accountability. We have no right to medicine-only access, contingent on supply chain logistics and quarterly earnings calls.
And yet, we don’t protest. We don’t riot. We just call our pharmacists, check ASHP, and hope.
This isn’t healthcare. It’s healthcare theater.
Compare this to the EU, where member states maintain strategic reserves and enforce price controls. Or Canada, where drug access is a constitutional right in practice, not just rhetoric. The U.S. doesn’t have a drug shortage crisis. It has a moral crisis disguised as an economic one.
And those who say ‘just buy from Canada’? They’re not helping. They’re enabling the myth that individual action can fix systemic rot. It can’t. Only policy can.
Until then, we’re all just waiting for the next tragedy to be reported in the news-and then forgotten by Monday.
People keep blaming China and India. But guess what? We’ve been outsourcing our medicine for 30 years because we’re lazy. We wanted cheap drugs and now we’re paying with our lives.
Meanwhile, the same people who scream about ‘buy American’ are the ones buying $1000 sneakers and ordering takeout 5x a week.
Wake up. This is what happens when you let greed dictate healthcare.
Also-yes, I know someone who got their Wegovy from Mexico. Don’t ask how. 😏
I’ve spent years listening to patients describe their fear when a drug disappears. Not anger. Not frustration. Fear. That quiet, hollow dread when you realize your treatment might not be there tomorrow.
It’s not about the science. It’s not even about the money.
It’s about the fact that we’ve built a system where human survival is treated like a commodity with fluctuating demand.
I wonder if the executives who approve cutting production lines ever think about the person who will miss their chemo because the vial never arrived.
Maybe if they did, they’d see it as a moral failure-not a business decision.
I don’t have solutions. But I see the cost. And I think we’ve forgotten how to grieve for things we’ve allowed to vanish.
bro in india we make most of these drugs but the quality control is trash sometimes... my cousin works in a pharma plant in hyderabad and he said they get pressure to ship fast, not right. FDA comes once every 2 years, and they clean up the place 2 weeks before. 😅
also, no one here gets paid enough to care. we make 5000 rupees a month but the drugs we make sell for $1000 in usa.
so yeah... its not just america. its the whole messed up system.
also, pls send memes. i need distraction from this.