Five Ways Health Systems are Staying Ahead of Drug Shortages

Drug shortages are persistent and increasingly difficult to manage in 2026. While chasing the lowest unit price might yield short-term budgetary wins, such isolated purchasing strategies are figurative band-aids on a systemic wound and fail to eliminate the underlying risk. To move from reactive shortage management to true disruption prevention and resilient supply of essential medications, the healthcare industry must pivot from defensive, isolated survival tactics to proactive, collaborative prevention strategies.

In a recent webinar in partnership with the End Drug Shortages Alliance, leaders from AdventHealth, Leiters Health, Fresenius Kabi and BayCare shared how this is playing out in practice. The following five moves can help hospitals and health systems stay ahead of drug shortages.

1. Discover Problems More Quickly by Knowing Where to Look

It’s no secret: As pharmaceutical supply pressures continue to build, the stability of essential medication access is becoming harder to sustain. “Drug shortages are here to stay,” said Saskia Crocker, Director of Corporate Quality & Regulatory Compliance at Leiters Health. “2024 was the worst year on record, and a lot of (the shortages) involve low-cost, generic sterile injectables. Millions of units are being used every year by hospitals, and patients critically need these drugs.”

Unfortunately, many of these shortages pose long-term risk. Some products cycle in and out of disruption, while others remain constrained for years at a time, pointing to deeper structural issues within the supply chain. 

“Quality signals (such as) observations and warning letters are probably the most predictive,” said Joel Rosenstack, President of Pharmaceuticals at Fresenius Kabi. “And once a manufacturer starts allocating, supply is usually fairly tight.”

Early action on these warning signs can help avoid more constrained and costly supply conditions, and technologies such as CognitiveRx® are helping translate signals into shared visibility.

“We use Premier's CognitiveRx platform and find it to be a beneficial tool,” Crocker said. 

Premier’s CognitiveRx technology:

• Helps predict drug shortages with an 85 percent early detection rate and an average lead time of 156 days.*
• Surfaces drugs at high risk for predicted price increases with more than 96 percent accuracy.*
• Streamlines margin analysis and daily pharmacy operations.

*Data on file.

2. Make Quick, Data-Informed Clinical and Sourcing Decisions

When a critical drug suddenly vanishes from the market, health systems are thrust into crisis mode. Pharmacy leaders and clinicians must pivot to survival tactics to protect immediate patient needs. This reactive scramble forms the first line of defense against an unpredictable supply chain.

“The underlying economics of generic medicines matter,” Rosenstack said. “A long-standing race to the bottom has contributed to fragility in the supply chain. Focusing solely on the lowest cost can unintentionally increase the risk of shortages and supply disruptions.”

In practice, protecting the pharmacy supply chain means considering:

• Factors beyond price alone.
• How many manufacturers supply a product.
• The past consistency of that supply.
• Whether alternatives are available should conditions change.

“You quickly look at where the most critical uses are and start putting in conservation efforts around those disease states and indications, while you’re trying to sort out the longer-term availability and pipeline of product coming in,” said Gregory Strohs, Vice President of Pharmacy Business Services at AdventHealth.

3. Align Contracting and Manufacturing Commitments with Resiliency Goals

A more sophisticated approach to inventory intelligence might be the best weapon against pharmaceutical shortages. Moving past the failures of just-in-time logistics means health systems must actively share long-term volume projections with their manufacturing partners. Eliminating market guesswork is the critical first step toward building a resilient, buffer-protected clinical pipeline.

“Predictable demand allows for long-term planning,” said Rosenstack. “If we can accurately forecast future demand, we can execute on building reserves … without the risk of scrap. We can also invest in redundant API and finished dose manufacturing when future demand can be counted on.”

Solutions such as ProvideGx® help formalize that alignment, pairing member commitment with supply assurance and supporting a more stable production environment. 

“Premier's ProvideGx program, along with a couple other solutions, allows us to provide manufacturers with demand planning and that ‘this is how much we need this month’ market signal,” said BayCare’s Kyle Brauer. “(It helps) lower the peaks and valleys of purchasing and allow for more consistent supply.

“That's been important for us over the course of the last five or six years that we've been a part of the ProvideGX program. It's helped us in certain situations with emergency syringes, vincristine and (similar) products.”

4. Building Redundancy and Transparency Across the Supply Chain

Even with strong planning, disruptions happen. What matters is if the system can absorb them. Redundancy, whether in manufacturing site operations, suppliers or sourcing strategies, is becoming a core principle.

“[We’re seeing] more redundancy built into manufacturing, such as producing across multiple lines or sites,” Rosenstack said. “It doesn’t eliminate risk, but it reduces the likelihood of a single issue turning into a prolonged shortage.”

For outsourcing facilities, redundancy begins months in advance.

“If we see a drug is at risk of going on shortage, we’ll start qualifying suppliers (and) doing raw material testing and stability work,” said Crocker. “That can be a six- to nine-month process.

“You don’t want to wait until a product is already on the shortage list.”

Transparency is equally important. When visibility improves across stakeholders, response time shortens, and decisions become more aligned.

“You get real tangible information — what caused the issue, when the next batch is coming (and) what’s being done to fix it,” Strohs said.

5. Strengthening Trust and Accountability Across the Ecosystem

Institutional safety nets are only as strong as the commercial relationships that support them. True supply chain resilience cannot exist in a vacuum; it requires an active, uninterrupted dialogue between health system buyers and their manufacturing partners. 

“Communication, communication, communication — you’ve got to stay on it,” said Brauer. “As soon as you hear about something, keep bringing it up until people hear it and act on it.”

“When you pull manufacturers, health systems and others together, it becomes much more collegial,” Strohs added. “Everyone’s trying to find the same solution.”

This collaborative mindset might be the only viable path forward in an increasingly volatile pharmaceutical landscape. When health systems and suppliers look past short-term transaction costs and focus on mutual operational health, systemic vulnerabilities begin to dissolve. 

Moving forward, the true measure of supply chain leadership will be the strength and reliability of the partnerships left standing rather than the lowest negotiated price.