Drug Shortages: Q4 Update

December 2, 2025

Summary

Many drug shortages are long-lasting, with the majority carrying over year to year and the average duration exceeding four years.
Recent tariffs on pharmaceuticals, including those targeting imports from India, China, and the EU, may significantly impact drug costs and availability in the U.S.
Policy changes in 2025 include the introduction of Most Favored Nation pricing and new tariff structures, with certain exemptions and postponements affecting branded and generic drugs differently.

What is the current state of U.S. drug shortages?

As of November 20, 2025, there are 200 drug shortages, according to the American Society of Health-System Pharmacists (ASHP). This is down from 226 in July and 270 in April. In August 2025, the American College of Physicians declared that drug shortages are a public health crisis.

Though the number of shortages is decreasing, they remain a problem in the U.S. Eighty-nine percent of 2023 drug shortages carried over into 2024. And the average length of a drug shortage last year was more than four years.

There has been a lot of news this year related to tariffs on pharmaceuticals. Those tariffs could have an impact on drug shortages. About 35% of drug ingredients for generics come from India while 18% come from Europe and 12% from the U.S. An October 2025 analysis from US Pharmacopeia showed that over 675 U.S. medicines used at least one chemical exclusively procured from China. This included antibiotics and generic drugs for heart problems, seizures, cancer, and HIV.

An Ernst & Young report from April 2025 said that a 25% tariff on drug imports would increase drug costs by nearly $51 billion a year. This would then make drug prices go up by almost 13% if those costs were passed along.

Information on tariffs has changed throughout the year.

On August 21, a trade framework between the U.S. and European Union (EU) was formalized. Pharmaceuticals from the EU will either be charged a 15% tariff or Most Favored Nation (MFN) pricing, whichever is higher. As of September 1, MFN pricing on generic drugs and active pharmaceutical ingredients went into effect.

At the end of September, a 100% tariff on imports of any branded or patented pharmaceutical products was announced with an effective date of October 1, 2025. If companies agree to build a manufacturing plant in the U.S., there is an exemption to the tariff. That measure has since been postponed. Generic drugs are exempt from this tariff. Drugs from the EU are not subject to a 100% tariff—they are still subject to the 15% tariff announced over the summer.

As of early November, exports from India to the U.S. have a 50% tariff rate, and exports from China have a 47% tariff rate.

Recent drug shortage news:

In August, the FDA announced FDA PreCheck, an initiative to boost American drug manufacturing. FDA PreCheck aims to have drug companies engage in more frequent communication with the FDA at the beginning of their development and to streamline pre-application meetings and feedback. The goal is to speed up construction of drug manufacturing facilities in the U.S. A public meeting about PreCheck was held at the end of September.
In August, the FDA announced the end of the sodium chloride 0.9% IV solution shortage. The U.S. supply of this solution was affected when Hurricane Helene disrupted manufacturing at a facility in North Carolina in September 2024. Over 85% of healthcare providers reported shortages in November 2024.
In September, the Drug Shortage Compounding Patient Access Act of 2025 was introduced in the House of Representatives. It aims to improve access to essential medicines when there are drug shortages, allowing compounding pharmacies to step in to fill gaps in care.

Why do drug shortages occur?

Drug shortages happen for a variety of reasons, including supply chain issues, increased demand, regulatory changes, geopolitical issues, business decisions, and extreme weather events. An August 2025 article in the American Journal of Managed Care noted that 62.8% of American drug production facilities are in disaster-prone counties and so are more susceptible to severe weather.

How do drug shortages affect patients, pharmacies, and healthcare?

Drug shortages hit different populations differently.

Drug shortages have a significant impact on children’s hospitals — children’s hospitals usually have 25% more shortages than general hospitals. Children account for a smaller number of hospital patients and there are fewer manufacturers of drugs for children. Because of these factors, there are more drug shortages for this patient population and higher expenses related to those shortages. In 2023, approximately 50% of essential pediatric medicines were considered in shortage.

Older Americans are also more likely to feel the effects of a drug shortage. About 75% of those affected by a shortage are between 45 and 85.

Approximately 500,000 people are affected by the average drug shortage. In the fall of 2023, about 28% of Americans were affected by a shortage. And almost 50% of those impacted said they delayed or stopped using a drug because it was not available.

Drug shortages also increase out-of-pocket costs and insurance costs for consumers. Recent data indicated that there is a 16.6% rise in the price of a drug in shortage. The price of a substitute drug could also be significantly higher than that of the original drug.

Drug shortages can also affect those working in healthcare.

A 2025 hospital pharmacy drug purchasing trends report found that 75% of hospital pharmacy leaders thought drug shortages were one of their main procurement issues. These shortages cost hospitals about $900 million each year just in labor costs.

A recent poll from Medscape Medical News indicated that 45% of oncologists said shortages of some chemotherapy drugs had a negative effect on quality of care to their patients. And 42% of these oncologists said the shortages negatively affected patient outcomes.

With drug shortages, healthcare workers are sometimes not able to give patients the medicines they need and have to administer ones that are less effective. Healthcare workers may have to work overtime to find other drugs, and care could be delayed, too. The 2025 report said that 43% of hospital pharmacy leaders reported medication errors related to shortages. This was up from 38% in 2019.

What drugs are in shortage?

A 2025 American Society of Health-System Pharmacists report which covered the period January 2001 to September 2025 found that shortages of lorazepam injections (used to relieve anxiety) and triamcinolone injections (used to treat inflammation, allergies, arthritis, and more conditions) were still high. There were also major shortages of oral opioids.

The report also showed that as of September, 61 new drugs had gone into shortage this year. This number is down from 130 in 2024 and 156 in 2023.

There are also shortages in oncology medications. Shortages for these drugs are usually among injectables, which have complicated manufacturing requirements. That can mean they are more likely to encounter supply disruption.

Some drugs that have gone into shortage in the fall include:

Leucovorin calcium tablets to prevent side effects from certain medicines and increase levels of folate
Iodine and potassium iodide to treat an overactive thyroid, iodine deficiency, and protect thyroid from radiation effects from radioactive types of iodine
Chlorothiazide oral suspension to treat fluid retention caused by congestive heart failure, cirrhosis, kidney disease, or treatment with a steroid or hormone medicine
Oxacillin sodium injection to treat infections caused by some types of bacteria
Sufentanil injection to relieve pain during and after surgery or other medical procedures

Final thoughts

As we move into 2026, drug shortages are still a problem in the U.S., and the outlook for next year is unclear. Systemic challenges are continuing to exert pressure on drug availability. Many shortages are long-standing, and their resolution will take time.

VytlOne actively monitors drug shortages and proactively identifies alternatives to reduce patient impact.