When your prescription runs out and no pharmacy has it in stock, itâs not just inconvenient-itâs dangerous. In 2025, over 1,900 prescription drugs were in short supply across the U.S. and U.K., including critical medicines like insulin, antibiotics, and chemotherapy drugs. This isnât a one-time glitch. Itâs a growing crisis. And if youâre relying on one of these drugs, you need to know what to do now, not when the shelves are empty.
Why Medication Shortages Happen
Itâs not just bad luck. Most shortages come from a few broken parts of the system. A single factory making 85% of a generic drug can shut down over a tiny quality issue-and suddenly, millions are left without their medicine. Manufacturing delays, raw material shortages, and companies quitting unprofitable drugs all add up. The FDA says nearly half of all shortages since 2020 were caused by production problems, not demand spikes. For example, Semglee (a biosimilar insulin) vanished from shelves in early 2025. Patients didnât suddenly need more insulin. The problem? One manufacturer couldnât meet quality standards. And because so few companies make these drugs, there was no backup.What You Can Do Right Away
Donât wait until your last pill is gone. Start acting as soon as you hear about a shortage-or if your pharmacy says theyâre out.- Check the FDA Drug Shortage Database-itâs free, updated daily, and lists approved alternatives. Type in your drug name and it will show you what else is available.
- Call multiple pharmacies, including mail-order services. Some small independent pharmacies or hospital pharmacies may still have stock when big chains donât.
- Ask your pharmacist. Most major chains now have pharmacists trained specifically to help during shortages. They can check inventory across regional networks and even contact distributors on your behalf.
One patient in Nottingham spent three days calling seven pharmacies before finding Semglee. But another found it on the first try-because their pharmacist had access to a regional inventory system. Donât assume your local store has the full picture.
Therapeutic Alternatives: Are They Safe?
Not all substitutes are created equal. Some drugs have direct, FDA-approved replacements. Others donât. The key is understanding the difference. For insulin, Semglee and Lantus are considered interchangeable. That means your pharmacist can swap them without a new prescription-no doctor visit needed. But Toujeo or Tresiba? Those are different formulations. Switching to them requires a new prescription and often a dose adjustment. Antibiotics are trickier. When amoxicillin ran low, doctors started prescribing azithromycin instead. But itâs not the same. Azithromycin works differently, has different side effects, and can contribute to antibiotic resistance if used inappropriately. Never switch antibiotics on your own. For chronic conditions like rheumatoid arthritis or multiple sclerosis, alternatives might mean switching to a different class of drug. Sarilumab, for example, saw usage drop by 67% in the U.K. during its shortage. Patients were moved to other biologics-but only after careful review by their specialist. These switches arenât quick fixes. They require monitoring.
Insurance and Formulary Changes
Even if a drug is medically appropriate, your insurance might not cover it. During the Semglee shortage, Blue Cross NC changed its formulary to allow Lantus without prior authorization. But not all insurers did the same.- Call your insurer. Ask: âIs there an alternative drug on my planâs formulary for [your drug]?â
- Ask if theyâve waived prior authorizations or step therapy requirements.
- Request a temporary exception. Many insurers will approve a non-formulary drug for 30-90 days during a shortage.
One survey found 57% of patients were confused about coverage changes during shortages. Donât assume your co-pay will stay the same. Always confirm before filling a new prescription.
What About Foreign-Made Drugs?
In 2025, Hawaiiâs Medicaid program started allowing drugs approved in Canada, the U.K., or the EU to be used during shortages. These arenât knockoffs-theyâre the same pills made in the same factories, just sold under different names. The FDA has special rules (Section 804) that let these drugs enter the U.S. under emergency conditions. But this isnât something you can do on your own. You need a doctorâs prescription and a pharmacy thatâs licensed to import them. Some patients have turned to overseas online pharmacies. Thatâs risky. The FDA warns that many of these sites sell counterfeit or expired drugs. Stick to U.S.-licensed pharmacies-even if theyâre sourcing from abroad under official channels.What You Should Never Do
During shortages, people do desperate things. Hereâs what you must avoid:- Splitting pills-unless your doctor says itâs safe. Many drugs arenât designed to be split. Insulin, for example, canât be divided without losing accuracy.
- Skipping doses-even for a few days. Stopping blood pressure, seizure, or diabetes meds can cause serious harm.
- Buying from unverified websites-over 70% of online pharmacies selling prescription drugs are illegal. Many sell fake or contaminated products.
- Using someone elseâs prescription-even if itâs the same drug. Dosage, formulation, and medical history make this dangerous.
A 2025 survey found 32% of patients stopped their meds during a shortage. Half of them ended up in the ER or hospital. Donât be one of them.
How to Prepare for the Next Shortage
Shortages arenât going away. The FDA says 63% of current shortages will last longer than 18 months. Hereâs how to build resilience:- Keep a 30-day supply of critical meds if your doctor allows it. Some insurers cover extra refills during shortages.
- Know your alternatives. Ask your doctor now: âIf this drug becomes unavailable, what are my options?â
- Sign up for alerts. The FDA, ASHP, and Wolters Kluwer all offer free email alerts for drug shortages.
- Build a relationship with your pharmacist. Theyâre your best ally during these times. Tell them youâre on a high-risk medication and ask to be notified if it goes out of stock.
Patients who took these steps had a 68% success rate switching to alternatives. Those who waited until the last pill was gone? Only 21% found a safe solution.
When to Call Your Doctor
You donât need to figure this out alone. Contact your provider if:- You canât find your medication after calling 3+ pharmacies
- Your pharmacy says an alternative is available but youâre unsure if itâs right for you
- Youâve had to skip doses or change your routine
- Youâre experiencing new side effects after switching
Doctors arenât just prescribing-theyâre coordinating. Many now work with hospital pharmacists and regional drug networks to find solutions before patients are left stranded.
Final Thought: Youâre Not Alone
Drug shortages feel isolating. You might think youâre the only one struggling. But thousands are in the same boat. The system is broken. But you have power. You can ask questions. You can demand alternatives. You can use the tools available-FDA database, pharmacist support, insurer exceptions-to keep yourself safe.The goal isnât to fix the supply chain overnight. Itâs to make sure your health doesnât suffer while we wait for it to get better.
What should I do if my insulin is on shortage?
First, check the FDAâs Drug Shortage Database to see if your insulin has an approved alternative. If youâre on Semglee, Lantus is an interchangeable biosimilar-your pharmacist can switch you without a new prescription. Donât switch to Toujeo or Tresiba unless your doctor approves it, as those require dose adjustments. Call your insurer to confirm coverage, and ask your pharmacy if they can access regional stock.
Can I use a drug from another country during a shortage?
Only through approved U.S. pharmacies that are licensed to import under FDA Section 804 waivers. These are not the same as buying from random online sites. Medications from the U.K., Canada, or EU must be the same product made in the same facility, just labeled differently. Never order from websites that donât require a prescription or canât prove theyâre U.S.-licensed.
Why canât I just split my pills to make them last longer?
Many pills arenât designed to be split. Even if they look like they can be, the dosage may not be accurate. Insulin pens, blood thinners, and psychiatric meds are especially risky. Splitting can lead to under- or overdosing. Always ask your pharmacist or doctor before splitting any pill-even if it seems obvious.
How do I know if an alternative drug is safe for me?
Therapeutic equivalence doesnât mean identical. A drug can be approved as an alternative but still have different side effects, dosing schedules, or interactions. Your doctor and pharmacist should review your full medical history, current conditions, and other medications before switching. Never assume an alternative is safe just because itâs listed on the FDAâs site.
What if my insurance wonât cover the alternative?
Ask your insurer for a temporary exception or prior authorization override due to a drug shortage. Many insurers have emergency policies in place. If they say no, ask your doctor to write a letter explaining why the alternative is medically necessary. You can also request a 30-day supply on a non-formulary drug while you appeal.
Are there any free resources to track drug shortages?
Yes. The FDAâs Drug Shortage Database is free and updated daily. ASHP also maintains a public list of current shortages. Wolters Kluwer offers free email alerts for critical drugs. Sign up for these before you need them-donât wait until your prescription runs out.
Can pharmacists help me find alternatives without seeing my doctor?
In some cases, yes. For interchangeable biosimilars like Semglee and Lantus, pharmacists can switch you without a new prescription. For other drugs, they can recommend alternatives and contact your doctor on your behalf. Most major pharmacy chains now have shortage specialists who can coordinate with your provider to get you the right medication quickly.
How long do drug shortages usually last?
About 75% of shortages last over a year, and 58% last two years or longer. The FDA reports that manufacturing issues are the main cause, and fixing them takes time. Donât expect a quick fix. Start planning alternatives as soon as you hear about a shortage.
Ishmael brown
I don't care what the FDA says. 𤥠My cousin in Ohio got his insulin from a guy who 'knows people' on Telegram. It worked. For 3 months. Then he got sick. But hey, at least he didn't wait for paperwork. đ¨đ #FreedomMedicine
Aditya Gupta
Bro, just call 3 pharmacies and ask for the generic. No drama. I did it for my dadâs blood pressure med. Pharmacist was chill, found it in 20 mins. You got this! đŞ
Nancy Nino
Oh, so now we're supposed to be grateful that Big Pharma's greed is being 'managed' by a database update? How quaint. 𤥠I'll take my 30-day supply and my pharmacist's loyalty over your 'system' any day. And yes, I'm still mad about the 2023 metformin fiasco.
June Richards
Lol. You really think the FDA database is useful? I checked it last month. It said 'no shortage' for my thyroid med... while every pharmacy in Texas was out. đ¤Śââď¸ And don't get me started on 'interchangeable' - my endo had to write a 3-page letter just to get me switched. Don't waste your time.
Jaden Green
The entire premise of this article is naive. You're treating a systemic collapse as if it were a logistical hiccup. The pharmaceutical industrial complex is designed for profit, not patient care. The fact that you're being told to 'call seven pharmacies' is the symptom - not the solution. We are living under a pharmacologically feudal system where your survival hinges on your ability to navigate bureaucratic labyrinths. The FDA is not your ally. It is a regulatory fig leaf for corporate malfeasance. And yet, here you are, reading this like it's a DIY home repair guide.
Lu Gao
I love that people think splitting pills is a solution. đ I mean, sure, it looks easy - but have you ever tried splitting a 10mg extended-release tablet? Itâs like trying to divide a cloud. And no, your kitchen scale doesnât count. Just ask your pharmacist. Theyâve seen it all. đ
Angel Fitzpatrick
The real shortage? Trust. đľď¸ââď¸ The FDA, the manufacturers, the insurers - theyâre all in cahoots. Did you know the same factory that makes Semglee also makes the âCanadianâ version? But you canât buy it unless you jump through 17 hoops? Thatâs not a shortage. Thatâs a controlled scarcity. Theyâre keeping prices high by artificially limiting supply. And the âemergency importâ loophole? Itâs a PR stunt. They want you to think theyâre helping - while they profit from your desperation.
Donna Macaranas
I just started a new med last year and my pharmacist already warned me itâs on the watch list. So Iâve got a 60-day stash, a backup plan, and a saved email template to send to my insurer. Took 20 minutes. No drama. Just⌠planning. đą
Ed Di Cristofaro
Stop being so damn passive. If your drugâs gone, call your doctor and say, âIâm not dying because of a spreadsheet.â Theyâll move heaven and earth if you scream loud enough. I did. Got my med in 48 hours.
Lilliana Lowe
The articleâs use of âinterchangeableâ is misleading. Technically, the FDAâs interchangeability designation requires bioequivalence in 90% of the population under fasting conditions - a standard that rarely reflects real-world polypharmacy. Moreover, pharmacists are not trained to assess clinical equivalence across therapeutic classes. This is a dangerous oversimplification. One must consult the BE-therapeutic equivalence database, not merely rely on the FDAâs public-facing portal, which is notoriously outdated.
Melissa Melville
I live in Florida. We just got a shipment of Canadian insulin from a licensed pharmacy. Same bottle, same factory, different label. My grandma took it. No problems. People act like itâs smuggling. Itâs just⌠shopping smarter. đ¨đŚâ¤ď¸
Bryan Coleman
I used to be the guy who waited until the last pill. Then I got hospitalized. Now I keep a 45-day supply, call my pharmacist every month, and signed up for the FDA alerts. Itâs not glamorous. But Iâm alive. And Iâm not sorry.
Naresh L
Itâs funny. We have the technology to track every coffee order, every Netflix binge, every step we take. But when it comes to saving lives with a pill? Weâre stuck in the 1980s. Why canât there be a global, real-time inventory map for essential medicines? Is it really that hard? Or is profit more important than presence?