Five Strategies Health Systems Are Using to Stay Ahead of Drug Shortages
Drug shortages remain one of the most persistent challenges facing healthcare organizations in 2026. Hospitals and health systems continue to confront disruptions involving essential medications, particularly low-cost generic sterile injectables that are widely used in hospitals and critical-care settings. These shortages can create operational uncertainty, increase costs, complicate clinical decision-making and, most importantly, threaten consistent access to medications patients need.
For years, healthcare organizations have often responded to shortages after they occur, relying on emergency purchasing, inventory adjustments and clinical substitutions to manage immediate disruptions. While these measures can protect patients in the short term, they do little to address the structural weaknesses that make pharmaceutical supply chains vulnerable in the first place.
A more sustainable approach requires health systems to move beyond simply finding the lowest-priced product. Instead, hospitals and manufacturers increasingly need to consider supply reliability, manufacturing capacity, demand forecasting, supplier diversification, inventory resilience and transparent communication.
During a recent webinar conducted in partnership with the End Drug Shortages Alliance, leaders from AdventHealth, Leiters Health, Fresenius Kabi and BayCare discussed how healthcare organizations are working to build more resilient pharmaceutical supply chains. Their experiences point to five strategies that can help health systems identify risks earlier, make better decisions and reduce the impact of future disruptions.
1. Identify Supply Problems Before They Become Shortages
One of the most important steps in shortage prevention is identifying potential problems as early as possible.
Drug shortages rarely appear without warning. Changes in manufacturing capacity, quality concerns, regulatory actions, raw material constraints and production allocations can all provide indications that a particular medication may become difficult to obtain.
For healthcare organizations, recognizing these signals early can create valuable time to identify alternative suppliers, adjust purchasing strategies, evaluate clinical alternatives and build appropriate inventory.
“Drug shortages are here to stay,” said Saskia Crocker, Director of Corporate Quality & Regulatory Compliance at Leiters Health. She noted that 2024 was particularly difficult and that many shortages involved low-cost generic sterile injectable medicines that hospitals use in very large volumes.
The challenge is particularly significant because some shortages are temporary, while others can persist for extended periods. A product may move in and out of shortage repeatedly, creating uncertainty for pharmacy teams attempting to plan inventory.
Joel Rosenstack, President of Pharmaceuticals at Fresenius Kabi, pointed to quality-related signals as potentially useful indicators of future supply problems. Observations and warning letters can provide insight into manufacturing risks, while allocation by manufacturers may signal that available supply is already becoming constrained.
The earlier health systems identify these warning signs, the more options they have.
Technology can play an increasingly important role in this process. Data-driven platforms such as CognitiveRx are designed to provide healthcare organizations with greater visibility into potential supply disruptions.
According to the information shared during the webinar, Premier’s CognitiveRx platform has demonstrated an 85% early detection rate for predicted drug shortages, with an average lead time of 156 days. The platform also identifies drugs at risk of price increases and supports pharmacy operations and margin analysis.
Early warning does not eliminate a shortage, but it can change the way an organization responds. Instead of scrambling after inventory has already disappeared, pharmacy leaders can begin planning while alternatives are still available.
2. Combine Clinical and Sourcing Data for Faster Decisions
When a critical medication suddenly becomes unavailable, healthcare organizations must make rapid decisions.
Pharmacy leaders need to determine which patients and clinical situations are most dependent on the medication, how much inventory remains, whether alternative therapies exist and where additional supplies may be sourced.
These decisions can have significant clinical and financial consequences.
According to Rosenstack, the economics of generic medicines are an important part of the shortage problem. A prolonged focus on minimizing unit costs can contribute to a fragile supply environment in which manufacturers have limited incentives to maintain redundant capacity.
The lowest purchase price, therefore, may not always represent the lowest overall risk.
Health systems increasingly need to consider several factors when evaluating medication suppliers. These include the number of manufacturers producing a particular drug, historical reliability, manufacturing capacity, quality performance and the availability of therapeutic alternatives.
This approach can help organizations distinguish between a medication that is inexpensive but highly vulnerable to disruption and one that may cost slightly more but provides greater supply security.
Gregory Strohs, Vice President of Pharmacy Business Services at AdventHealth, described the need to prioritize medications according to their clinical importance.
When supply becomes constrained, pharmacy teams can identify the most critical uses of a medication and implement conservation strategies around particular diseases or indications while longer-term supply solutions are developed.
Such decisions require close collaboration between pharmacy professionals, physicians, supply chain teams and other clinical stakeholders.
The objective is not simply to purchase more medication. It is to ensure that limited supply is directed toward the patients and clinical situations where it is most needed.
3. Align Purchasing Commitments With Manufacturing Capacity
Long-term supply resilience requires closer alignment between healthcare organizations and pharmaceutical manufacturers.
Traditional just-in-time inventory models can reduce the amount of stock a health system needs to hold, but they can also leave organizations vulnerable when unexpected disruptions occur.
A more resilient model involves healthcare organizations providing manufacturers with better visibility into future demand.
Predictable demand allows manufacturers to make more informed decisions about production capacity, raw materials and inventory reserves.
“Predictable demand allows for long-term planning,” Rosenstack said. He explained that accurate demand forecasts can help manufacturers build reserves without creating excessive product waste and can support investment in redundant active pharmaceutical ingredient and finished-dose manufacturing capacity.
This is where programs such as ProvideGx can play a role by connecting healthcare demand with manufacturing commitments.
BayCare’s Kyle Brauer explained that the organization has used the ProvideGx program to give manufacturers clearer signals about anticipated demand.
Providing manufacturers with information about how much product a health system expects to need can help reduce extreme fluctuations in purchasing.
Rather than manufacturers responding to unpredictable spikes and declines in orders, improved forecasting can create a more stable demand environment.
Brauer said the approach has been valuable for BayCare over several years, including in situations involving emergency syringes, vincristine and other products.
The broader lesson is that demand visibility can become a supply-chain asset. When manufacturers understand future requirements, they may be better positioned to plan production and maintain appropriate reserves.
4. Build Redundancy and Transparency Into the Supply Chain
Even the most sophisticated forecasting system cannot eliminate every supply disruption.
Manufacturing problems, natural disasters, regulatory actions, raw material shortages and unexpected increases in demand can still affect pharmaceutical availability.
For this reason, redundancy is becoming an increasingly important component of healthcare supply-chain strategy.
Rosenstack noted that manufacturers are increasingly building redundancy into production by using multiple manufacturing lines or facilities.
Having multiple production options does not eliminate risk, but it can reduce the likelihood that a single manufacturing problem will create a prolonged shortage.
For outsourcing facilities, preparing for a potential disruption may require months of work.
Crocker explained that when Leiters Health identifies a medication as being at risk of shortage, the company may begin qualifying suppliers, testing raw materials and conducting stability work.
That process can take six to nine months, demonstrating why preparation must begin well before a medication officially appears on a shortage list.
Waiting until a product is already unavailable may leave too little time to qualify a reliable alternative.
Supply-chain transparency is equally important.
Healthcare organizations need to know why a product is unavailable, when the next production batch is expected and what steps manufacturers are taking to address the problem.
According to Strohs, better information can give health systems actionable details about the cause of a disruption and the expected timing of future supply.
Greater transparency enables pharmacy and procurement teams to make better decisions about inventory, clinical alternatives and purchasing.
5. Strengthen Relationships Between Health Systems and Manufacturers
Technology, forecasting and redundancy are important, but supply-chain resilience ultimately depends on collaboration.
Healthcare organizations and manufacturers must maintain open communication before, during and after a disruption.
Brauer emphasized the importance of consistent communication when a potential supply problem emerges. Rather than raising an issue once and waiting for a response, healthcare organizations need to remain engaged until the problem receives appropriate attention.
This type of communication can help ensure that emerging risks are identified and addressed before they become larger problems.
Strohs also emphasized the value of bringing manufacturers, healthcare systems and other stakeholders together.
When participants have visibility into each other’s challenges, they can move away from transactional relationships and focus on shared solutions.
For example, a hospital may be experiencing unexpected demand while a manufacturer is facing production constraints. Understanding both sides of the problem can help stakeholders identify practical approaches that might otherwise be missed.
This collaborative model is increasingly important as pharmaceutical supply chains become more interconnected.
Moving From Reactive Management to Prevention
The continuing prevalence of drug shortages demonstrates that healthcare organizations cannot rely solely on emergency responses.
Reactive strategies remain necessary. Hospitals must be able to conserve medications, identify alternatives and secure emergency supplies when disruptions occur. However, these actions should form only one part of a broader resilience strategy.
The more sustainable approach is to identify risks before shortages occur and develop contingency plans while options remain available.
That means monitoring quality and manufacturing signals, using data to predict potential shortages, considering supply reliability alongside price, improving demand forecasting, establishing redundancy and maintaining open communication with suppliers.
The five strategies highlighted by healthcare and pharmaceutical leaders provide a framework for achieving this transition.
Early visibility gives health systems more time to respond.
Data-informed clinical and sourcing decisions help organizations protect the most important uses of constrained medications.
Demand planning and contracting alignment can provide manufacturers with the information needed to support stable production.
Redundancy and transparency reduce the impact of individual supply disruptions.
Strong partnerships and communication allow stakeholders to work together when problems emerge.
Resilience May Become More Important Than Lowest Price
One of the most significant changes in pharmaceutical supply-chain thinking is the growing recognition that price cannot be the only purchasing consideration.
A medication with the lowest unit cost may not deliver the lowest overall cost if it becomes unavailable and forces hospitals to purchase emergency alternatives at significantly higher prices.
Shortages can also create indirect costs through additional pharmacy labor, inventory management, clinical substitutions and potential treatment delays.
As a result, healthcare organizations are increasingly evaluating suppliers and contracts based on a broader definition of value.
Reliability, manufacturing redundancy, quality performance, transparency and long-term availability can all contribute to the true value of a medication supply agreement.
The goal is not necessarily to pay more for every product. Rather, it is to make purchasing decisions based on the total risk associated with maintaining reliable access to essential medicines.
A More Collaborative Future for Pharmaceutical Supply
Drug shortages are unlikely to disappear entirely. Pharmaceutical manufacturing is complex, global supply chains remain vulnerable to disruption and demand can change quickly.
However, healthcare organizations can become better prepared.
The experiences shared by AdventHealth, Leiters Health, Fresenius Kabi and BayCare demonstrate that resilience requires action well before a shortage reaches a hospital pharmacy.
Health systems need better information about emerging risks. Manufacturers need clearer demand signals. Pharmacy leaders need tools that support rapid decision-making. And both sides need relationships based on transparency and accountability.
Ultimately, the future of drug shortage management will depend on moving from short-term reactions toward long-term prevention.
For healthcare organizations, success will increasingly be measured not simply by how quickly they respond after a medication becomes unavailable, but by how effectively they identify risks, diversify supply, plan ahead and collaborate with manufacturers before disruption occurs.
In an increasingly unpredictable pharmaceutical environment, the strongest supply chains will not necessarily be those that secure the lowest price. They will be those capable of maintaining reliable access, clinical continuity and operational stability when disruptions occur.
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