Drug shortages have become an ongoing challenge for healthcare providers, but a new analysis suggests the next disruption may not come from medications already in shortage.

According to a recent report highlighted by The Center for Infectious Disease Research and Policy (CIDRAP), the U.S. Pharmacopeia (USP) identified 100 essential medications that face significant supply chain vulnerabilities. While many remain readily available today, underlying risks—including limited supplier diversity, manufacturing complexity, and reliance on single-country sourcing—could make future disruptions more likely.

Key Findings

• USP identified 100 essential medications with significant supply chain vulnerabilities
• Approximately 70% are not currently experiencing shortages
• Nearly two-thirds are injectable medications
• Many rely on limited manufacturing capacity or single-country sourcing for key ingredients
• More than three-quarters of the medications identified are commonly encountered in long-term care settings

What makes this particularly relevant for long-term and senior care providers is the number of medications on the list that are routinely used in skilled nursing and assisted living settings. These include antibiotics, pain management therapies, IV solutions, seizure medications, corticosteroids, and other treatments that play an important role in resident care.

The report highlights an important reality: many organizations may have little visibility into risks that exist further upstream in the supply chain. A medication can appear stable and available today while still being vulnerable to future disruptions caused by manufacturing, sourcing, or distribution challenges.

Why This Matters Beyond the Pharmacy

For long-term and senior care facilities, and the pharmacies that support them, medication supply disruptions can create challenges that extend well beyond procurement. When commonly used medications become difficult to obtain, organizations may face:

• Additional physician orders and medication regimen changes
• Increased clinical monitoring when therapeutic alternatives are required
• More staff education and communication surrounding medication substitutions
• Resident and family concerns related to treatment changes
• Potential impacts on workflow, medication administration, and continuity of care

In some cases, alternative therapies may not provide the same clinical outcomes or may introduce new considerations for residents with complex medical conditions.

The findings also reinforce the importance of strong pharmacy partnerships. Long-term care pharmacies routinely monitor supply availability, identify therapeutic alternatives when appropriate, and work collaboratively with providers to minimize disruptions to resident care. Clinical oversight becomes especially important when shortages affect medications used to manage chronic conditions, infections, pain, behavioral health concerns, or acute changes in condition.

No provider can eliminate supply chain risk entirely. However, organizations that maintain strong communication with their pharmacy partners, proactively review medication utilization patterns, and stay informed about emerging shortages are often better positioned to respond when disruptions occur.

While the medications on USP’s list may not be in shortage today, the report serves as a reminder that maintaining continuity of care depends on more than what’s currently on the shelf. Understanding where vulnerabilities exist—and planning ahead—can help protect resident outcomes when supply chain challenges emerge.