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My first exposure to pharmaceutical shortages happened in 2017 as a new-to-practice nurse working on an inpatient oncology unit. A hurricane in Puerto Rico had left the U.S. short of sodium chloride minibags. Health care providers nationwide were tasked to modify standard medication preparation and administration practices, such as changing medications from IV to oral delivery, avoiding prepping IV lines with saline, or providing IV drugs by push rather than infusion. I was working in a heavily resourced academic institution. It felt absurd that I couldn’t even appropriately administer medications, but I figured this was an emergency.

Eventually, the shortage ended. But it was not an isolated incident.

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The recent spotlight on shortages of essential medicines, such as cancer therapies and ADHD drugs, has brought attention to a longstanding public health crisis. Prescription drug shortages across drug classes have been on the radar of our governing bodies for decades. Nearly 10 years ago, up to 83% of oncologists surveyed could not prescribe a preferred chemotherapy agent due to shortages. Yet, the problem persists, with new shortages being identified at alarming rates. Recent reports indicate drug shortages grew by 30% in the past year. At the end of 2022, there were national shortages of 295 medications, including essentials like anesthetics, chemotherapies, and antibiotics.

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