The Warning Signs of a Drug Shortage are Already in the Data

Drug shortages are not a new challenge for healthcare. But when the drugs in short supply are foundational to cancer treatment, the consequences of a fragile supply chain become increasingly difficult to ignore.

Across the country, cancer centers are closely monitoring supplies of widely used generic chemotherapy drugs as manufacturing disruptions, raw material pressures and supplier exits strain availability. In some cases, providers have been forced to consider spacing out doses, evaluate alternative treatments and prioritize limited supplies for patients most likely to benefit.

Premier’s latest fill-rate data offers a closer look at the growing pressure.

When Chemotherapy Drug Fill Rates Enter the Danger Zone

Fill rates measure how much of a drug order healthcare providers actually receive. At Premier, generally a fill rate below 80 percent is considered the “danger zone,” an indication that supply may no longer be keeping pace with demand.

For cisplatin, a chemotherapy drug used to treat ovarian, testicular and bladder cancers, Premier data from June 2026 shows fill rates have fallen to approximately 66 percent. Premier has seen reports indicating that the shortfalls may be tied to raw material shortages and price increases.

The situation is even more acute for ifosfamide, a drug used in the treatment of cancers including lymphoma, sarcoma and lung cancer. Premier data shows fill rates fell to approximately 37 percent in May 2026 and continued to decline into June.[1] Manufacturing disruptions, slower-than-anticipated recovery and reduced supplier availability have further constrained supply.

These numbers are more than a measure of product availability. They can serve as an early warning of the difficult decisions health systems may soon face.

When Supply Falls, Providers Have Fewer Options

When critical medication becomes difficult to secure, the impact can quickly extend beyond the pharmacy.

Clinicians and pharmacy teams may need to evaluate therapeutic alternatives, adjust treatment schedules or develop strategies to conserve the inventory they have on hand. Recent reports have highlighted providers reviewing which patients should remain on standard treatment and where alternative therapies may be appropriate. Some organizations have also spaced-out doses or scheduled patients consecutively to reduce waste.

The challenge is particularly pronounced for older generic medications. Many of these drugs remain essential to patient care but are vulnerable to manufacturing disruptions, supplier exits and raw material pressures. In a market with a limited number of manufacturers, a disruption at one facility or the loss of one supplier can quickly ripple across the broader healthcare supply chain.

By the time orders go largely unfilled, health systems may already be operating in crisis mode. The more important question is: How much earlier could they have seen the risk coming?

Earlier Warning Can Create More Time to Act

Healthcare supply chain teams have traditionally spent significant time reacting to disruptions after they occur. But data and predictive analytics are creating opportunities to identify potential constraints sooner.

Premier’s Supply Disruption Manager uses real-time data and predictive analytics to identify potential supply risks and provide actionable insights to help organizations maintain continuity. Predictive models can analyze organization-specific supply consumption, inventory and ordering patterns to help healthcare leaders better understand where vulnerabilities may emerge.

For example, Premier’s work with Renown Health demonstrated how predictive analytics could identify supplies likely to become constrained three to six weeks in advance. That additional time allowed supply chain and clinical teams to establish substitutes, develop conservation plans and proactively address hundreds of potential shortages before patient care was impacted.[2]

For critical drugs, those additional weeks can be valuable.

Earlier visibility can give pharmacy, supply chain and clinical leaders time to assess available inventory, collaborate on clinically appropriate alternatives and determine how existing supply should be managed before a disruption reaches a critical point.

Building a More Resilient Pharmacy Supply Chain

Technology alone can’t solve the structural challenges contributing to drug shortages. Long-term supply resiliency also requires strategies designed to strengthen the supply chain, diversify sourcing options and help providers respond more effectively when disruptions occur.

Premier’s ProvideGx® program was created to help mitigate drug shortages and promote a more stable supply of critical generic medications. Through long-term purchasing commitments and partnerships with pharmaceutical manufacturers, the program is designed to encourage steady production, adequate safety stock and the ability to respond to increases in demand. Today, the ProvideGx program gives Premier members access to more than 150 generic medications that are or have recently been on the national drug shortage list, including cisplatin.

Compounding can also play an important role in strengthening supply resiliency. When commercial manufactures face shortages, compounded medications can provide an alternative source of supply, helping hospitals maintain continuity of care while reducing reliance on costly last-minute purchases. Customized compounded formulations may also help address gaps when commercially available products can’t meet patient or procedural needs.

Building a resilient compounding strategy requires more than identifying an alternative supplier. Healthcare organizations need confidence that compounded medications meet rigorous quality, safety and compliance standards while maintaining visibility into potential shortages before they escalate. Premier supports their efforts through access to a broad network of vetted 503A and 503B suppliers, supplier evaluations and real-time shortage visibility that help pharmacy teams make informed sourcing decisions more quickly.

Together, predictive analytics, proactive sourcing strategies and outsourced compounding can give healthcare organizations more options when supply begins to tighten.

Health systems can’t prevent every manufacturing disruption, raw material shortage or supplier exit. But they can strengthen their ability to see risk sooner and respond before a shortage begins to affect patient care.

As fill rates for critical drugs continue to fluctuate, the goal should not simply be to manage the next shortage. It should be to build a supply chain that is better prepared for the warning signs.

For more:

• Explore how Premier Pharmacy solutions help healthcare organizations anticipate challenges, strengthen supply strategies and support continuity of care.

Footnotes:

[1] Data on file.

[2] Data on file. Results for each health system may vary.