Some critical drugs have been in shortage for more than 8 years

Person working in drug-manufacturing facility

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At least 20 critical drugs have been intermittently in shortage since 2015, according to the American Society of Health-System Pharmacists (ASHP) database. All but three of these drugs are also on the Resilient Drug Supply Project's (RDSP's) Critical Acute and COVID-19 Drug List. The US Food and Drug Administration's (FDA's) drug shortage database includes some, but not all, of the drugs as being in shortage.

RDSP is part of the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP), publisher of CIDRAP News.

In 2018, a team of RDSP members and pharmaceutical, public health, and clinical healthcare experts from government, academia, and the private sector created a list of 156 critical acute drugs, a lack of which would lead to serious health outcomes, including death or the inability to provide humane care.

Affected drug supplies

The drugs in both ASHP's database and the RDSP critical acute drug list in frequent shortage over the past 8 years include certain formulations of the following drugs—with the number of manufacturers reporting no, limited, or backordered supplies due to increased demand, manufacturing delays, or discontinuation this year in parentheses:

  • Acetylcysteine oral and inhalation solutions (3)
  • Atropine sulfate injection (5)
  • Black widow spider antivenom (1; sole manufacturer)
  • Bupivacaine injection (5)
  • Clindamycin phosphate injection (5)
  • Dexamethasone sodium phosphate injection (3)
  • Diltiazem hydrochloride injection (2; a third, Akorn Pharmaceuticals, shuttered its operations in 2022)
  • Doxorubicin injection (3)
  • Ketorolac injection (3)
  • Levetiracetam injection (2)
  • Lidocaine injection (5)
  • Lidocaine with epinephrine injection (2)
  • Lorazepam injection (4)
  • Magnesium sulfate injection (3)
  • Morphine injection (4)
  • Vancomycin hydrochloride injection (4)
  • Vecuronium bromide injection (3)

The drugs listed only in ASHP's shortage database are:

  • Cefotaxime sodium injection (2)
  • Leucovorin calcium injection (4)
  • Multiple vitamins for infusion (Infuvite) (1; sole manufacturer since Pfizer stopped making it in 2021)

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