Addressing and managing drug shortages

Drug shortages, defined as a period of time in which demand exceeds supply, pose a significant risk to patient care. Drug shortages result in delays and discontinuations of treatment and may take years to resolve. 

The AMA has declared drug shortages to be an urgent public health crisis and a national security threat and is actively working to limit the impact on practice.

Sterile fluids shortage: Clinical guidance for practices

Find practice guidance and communications for management of the current IV fluid shortages.

• Baxter have extended the expiration dates for some products manufactured before Sept. 30, 2024: See this resource (PDF) for product codes and new expiration dates.
• CMS waive certain Medicare quality reporting (PDF) due to Hurricane Milton and Helene
• Substitutions and practice changes:
  • Small- and Large-Volume Fluid Shortages: Suggestions for Management and Conservation (American Society for Health-System Pharmacists and the University of Utah Drug Information Service)
  • Intravenous Fluid Shortage Strategies (Department of Health and Human Services)
• Ordering and alternate product sourcing: Guidance for navigating medical supply chain disruptions caused by Hurricane Helene (ECRI)
• Temporary importation sources and compounding guidelines:
  • Hurricane Helene: Baxter's manufacturing recovery in North Carolina (U.S. Food and Drug Administration)
  • Fact Sheet: Biden-Harris Administration Takes Action to Ensure Americans Can Access Medical Supplies Following Hurricanes Helene and Milton (Department of Health and Human Services)

Communications on impacts of Hurricane Helene

• AMA letter to U.S. Department of Health and Human Services on Response to Hurricane Helene (PDF) (Oct. 10, 2024)
• More Than 86 Percent of Providers Experiencing Shortages of IV Fluids in Aftermath of October Hurricanes (Premier, Inc., Oct. 10, 2024)
• Letter to Health Care Leaders and Stakeholders on Impacts of Hurricane Helene from Secretary Becerra (Department of Health and Human Services, Oct. 9, 2024)

Updates/resources on the ongoing drug shortage

• JAMA Network Open™: Treatment Modifications After Drug Shortages Among Primary Care Physicians
• Current Drug Shortages Database from the American Society of Health System Pharmacists.
• The U.S. Food and Drug Administration provides a current shortages list, extended use dates, mobile app and additional information:
  • FDA drug shortage list
  • FDA drug shortages FAQ
• AMA Update: Fixing pharmaceutical supply chains, medication shortages & rationing in medicine

General background and policy considerations

• The AMA Council on Science and Public Health publishes an annual report providing an overview of drug shortages and policy recommendations.
• AMA Journal of Ethics® discusses how critical medications should be rationed during shortages.
• Association of State and Territorial Health Officials publishes a policy toolkit for health agency program leadership on improving access to critical medications.
• U.S. Pharmacopeia provides a call-to-action report on solving drug shortages. 

HHS resources

• Department of Health and Human Services has released a white paper on preventing drug shortages. 

AMA advocacy efforts

The AMA actively advocates with members of Congress, various congressional subcommittees and multiple federal agencies. Learn more about these efforts:

• The AMA is a founding member of the Drug Shortages Task Force. See the Call to Action, policy initiatives, and stories from the community here.
• AMA letter to Senate on draft legislation to combat prescription drug shortages (PDF)
• AMA letter to Federal Trade Commission on drug shortages (PDF)
• Combating drug shortages requires multifaceted approach (by Bruce Scott, MD, AMA immediate past president)
• Reforms needed to alleviate persistent drug shortages (by Jesse Ehrenfeld, MD, AMA past president)
• Time for new ideas to address rising drug shortages
• AMA strengthens policy to address growing national drug shortages