Drug shortage update: How 2025’s drug supply chain is evolving

Drug shortages remain a significant issue in the United States in 2025. As of April 17, there are 270 active drug shortages, according to the American Society of Health-System Pharmacists (ASHP). While this is a slight decrease from the 277 reported in September 2024, the problem is far from resolved. Notably, more than 40% of the current shortages began in 2022 or earlier.

Most drug shortages last around 18 months, but half extend beyond two years. The Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the Department of Health and Human Services estimates that the average drug shortage impacts approximately 500,000 people—and more than 30% of those affected are between the ages of 65 and 85.

What’s causing the shortages?

Drug shortages stem from a complex mix of factors, including:

• Manufacturing quality
• Availability of raw materials
• Increased demand
• Supply chain disruptions
• Pricing challenges
• Regulatory changes
• Geopolitical tensions
• Discontinuation of drugs
• Extreme weather events

For example, natural disasters have directly impacted drug manufacturing in recent years. A tornado in North Carolina in July 2023 damaged a Pfizer plant responsible for producing 15 drugs. Just over a year later, Hurricane Helene disrupted operations at a Baxter International facility that manufactures IV fluids. Even global weather events have played a role—extreme heat and humidity in Sweden in 2018 forced a pharmaceutical company to reduce production at one of its factories.

In another instance, a 2022 FDA inspection of a facility in India—responsible for producing about half of the U.S. supply of the chemotherapy drug cisplatin—revealed quality control issues. Production was halted, resulting in a nationwide shortage.

Demand spikes, paired with regulatory hurdles, have also contributed to recent shortages. ADHD medications and GLP-1 drugs for weight loss have been in particularly short supply due to rising usage.

Could tariffs increase drug shortages?

Analysts warn that proposed pharmaceutical tariffs could exacerbate supply issues. Over 50% of drugs used in the U.S. are manufactured abroad. If implemented, tariffs ranging from 50% to 200% could disrupt an already fragile global supply chain.

Generic sterile injectable drugs—like chemotherapy medications and IV saline—are particularly vulnerable due to their complex manufacturing processes and low profit margins. More broadly, generic drugs (which account for 90% of prescriptions filled in the U.S.) could face increased pressure, as many rely on raw materials from China and India.

In contrast, brand-name drug manufacturers—with higher margins and more domestic facilities—may be better positioned to absorb the impact of potential tariffs.

Which drugs may be affected?

While the future of tariffs remain uncertain, the drug classes most likely to be negatively impacted include:

• Central nervous system agents
• Antimicrobials
• Fluids and electrolytes
• Hormonal agents
• Chemotherapy drugs

Examples of drugs currently in shortage:

• Pimecrolimus 1% cream (for atopic dermatitis)
• Lidocaine (various forms: transdermal patches, injections, oral solution)
• Epinephrine (auto-injectors and injections)
• Clonazepam oral tablets (for anxiety)
• Varenicline tablets (Chantix, for smoking cessation)
• Mitomycin and Methotrexate injections (for cancer treatment)
• Minoxidil 2.5 mg tablets (for high blood pressure)
• Moxifloxacin tablets (antibiotic)
• Fluconazole injections (for fungal infections)
• Methylphenidate transdermal system (for ADHD)

What’s next?

The outlook for drug shortages in 2025 remains uncertain. While there are ongoing efforts to address systemic challenges—such as increasing domestic manufacturing and enhancing supply chain transparency—the situation remains fluid. Policymakers, manufacturers, and healthcare providers will need to work together to mitigate risks and prevent future disruptions in patient care.

Further reading

• The current state of U.S. drug shortages
• Pharmacy deserts: A growing problem in the U.S.

References

• Drug Shortages Statistics. American Society of Health-System Pharmacists.
• Impact of Drug Shortages on Consumer Costs. U.S. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. May 2023.
• McPhillips, Deidre. Drug shortages reach record high in US. CNN. April 12, 2024.
• Wosinska, Marta. Drug shortages: A guide to policy solutions. Brookings Institution. March 13, 2024.
• Drug Safety: FDA Should Take Additional Steps to Improve Its Foreign Inspection Program. U.S. Government Accountability Office. January 7, 2022.
• Tirrell, Meg, Bonifield, John, and Branda Goodman. Pfizer advises hospitals on products with limited inventory after tornado damages manufacturing plant. CNN. July 25, 2023.
• Johnson, Steven Ross. Hurricane Helene Leaves IV Fluid Shortage in its Wake. U.S. News and World Report. October 17, 2024.
• Mathews, Shilpa. The pharmaceutical sector must find a remedy for climate-related risks. Oxford Economics. November 11, 2024.
• Serino, Kenichi. A ‘perfect storm’ led to an ADHD medication shortage. Here’s why. PBS. July 18, 2023.
• Uscher, Jen, and Zack, Liz. How to Navigate a Chemo Drug Shortage. Breastcancer.org.
• Gilbert, Daniel. How troubles at a factory in India led to a U.S. cancer-drug shortage. The Washington Post. June 27, 2023.
• Constantino, Annika Kim. Trump’s pharmaceutical tariffs could raise costs for patients, worsen drug shortages. CNBC. April 11, 2025.
• Weixel, Nathaniel. Trump pharma tariff threat raises specter of shortages, price hikes. The Hill. April 14, 2025.
• Current Drug Shortages. American Association of Health System Pharmacists.

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