Active drug shortages in the U.S. reached 223 in the first quarter of 2026, increasing for the second consecutive quarter, according to an April report from the American Society of Health-System Pharmacists.
That upward trend comes as global supply risks intensify. The U.S. relies heavily on overseas manufacturing for generic drugs, with India supplying roughly 47% of volume and depending on shipping routes affected by the U.S.-Iran conflict — disruptions that could further strain availability of essential medications.
Here are five notes from the report:
• Shortages remain below peak levels: While active drug shortages reached 223 in the first quarter of 2026, they are still below the all-time high of 323 recorded in the first quarter of 2024.
• Controlled substances affected: Fifteen percent of shortages involve controlled substances, creating challenges for patients with chronic pain or ADHD and complicating medication access for surgeries and procedures.
• Most shortages are recent: About 77% of active shortages began in 2022 or later, reflecting ongoing instability in the drug supply chain.
• Patient impact can be broad: Fewer shortages do not necessarily mean fewer patients affected, as a single shortage can disrupt care for large populations.
• Operational burden growing: Managing shortages is increasing workload for hospital pharmacy teams, requiring changes to automation systems, EHR workflows and care protocols.
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