Drug Shortages Remain a Global Headache for Health Systems

Drug shortages are no longer a temporary disruption or a problem confined to one market. In 2026, they remain a persistent pressure point for health systems, regulators, and frontline clinicians alike. The issue may look different from country to country, but the pattern is familiar: fragile supply chains, manufacturing problems, demand spikes, and geopolitical disruptions continue to expose how little slack exists in the global medicines system. The FDA says shortages still commonly stem from manufacturing and quality problems, delays, and discontinuations, while the EMA continues to treat medicines availability as a major priority across the EU.

The U.S. picture shows the problem has hardly disappeared. ASHP’s latest statistics put active drug shortages at 216, up slightly from the previous quarter, even if below the record high reached in early 2024. The same update notes that 15% of active shortages involve controlled substances, affecting areas such as chronic pain, ADHD treatment, surgeries, and procedures. That matters because the operational burden of shortages extends well beyond procurement. It forces hospitals and pharmacists into substitution planning, inventory workarounds, and clinical adjustments that can ripple through patient care.

Europe is dealing with the same structural vulnerability, even where immediate crisis conditions are not yet severe. In March 2026, EMA said there were no reports of current critical shortages linked to recent transport disruptions, but it also stressed that companies were already reporting interruptions to air freight and maritime routes, rising costs, and a highly dynamic situation in which risks could increase if disruption persists. EMA has also recently added new sections on critical shortages and supply-chain vulnerabilities, which signals how seriously the issue is being monitored.

What makes shortages so difficult is that they are rarely caused by a single event. OECD work has highlighted that medicine shortages were already common in many countries before COVID-19 and that the pandemic exposed deeper supply-chain weaknesses rather than creating them from scratch. The same structural fragility still applies today: concentrated manufacturing, limited redundancy, dependence on global inputs, and procurement systems that often reward low cost over resilience.

Recent shortage examples underline how varied the triggers can be. In the U.S., some products remain constrained because of missing active ingredients, manufacturer discontinuations, allocation limits, or long back-order timelines. The result is not one shortage story but many overlapping ones, each with different causes and different implications for care delivery.

That is why the shortages conversation is increasingly shifting from emergency response to system resilience. Regulators can help mitigate disruptions, extend use dates, coordinate reporting, and publish shortage information, but none of that fully solves the core challenge. Health systems still need more reliable manufacturing capacity, better visibility into supply risk, and stronger incentives for resilience. Until that happens, drug shortages will remain less of a passing headline and more of a recurring operational reality for healthcare.

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