Active drug shortages fell 23% in 2025, but shortages are lasting longer than ever, according to U.S. Pharmacopeia’s 2025 Annual Drug Shortages Report. Here is what health system pharmacy leaders need to know:
- Median shortage duration climbed to five years in 2025, up from 4.3 years in 2024 and just two years in 2019. More than half of drugs in shortage, 64%, have been in shortage for more than three years, and 39% for more than five years.
- Drug discontinuations jumped 60% year over year, the largest single-year increase since 2019. Two-thirds of discontinued oral solid dosage products were priced below $1 per unit, with median prices falling 78% in one year. More than one-third of discontinued injectables were priced below $15 per unit.
- Sterile injectables make up 71% of active shortages. Low prices, geographic concentration, manufacturing complexity, and quality concerns remain the four interconnected root causes USP has consistently identified.
- Pediatric drugs are the most affected therapeutic category, with 16 shortages — compared to just six in oncology. Six of those involve IV fluids and additives, which can cascade into shortages across other drug classes by constraining diluents and altering dosing protocols.
- USP’s shortage risk prediction model hit 96% overall accuracy. When it flagged a drug as at-risk, predictions were correct 80% of the time, and the model captured 82% of all active shortages reported by the FDA and the American Society of Health-System Pharmacists.