Medicine shortages have become a defining challenge for community pharmacies across the globe, disrupting patient care, reshaping workflows, straining resources, and testing the resilience of health systems.
What was once an occasional disruption is now a daily reality from Europe to North America, Asia to Australia — a trend the World Pharmacy Council warns is worsening, not stabilising.
Stephen Armstrong, Chief Economist at the WPC, says the evidence is clear. “The data indicate medicine shortages are occurring more frequently across all regions, and the trend has been consistent for several years.”
For pharmacists, the consequences are immediate and deeply personal. Every unavailable product represents a patient whose treatment plan suddenly becomes uncertain. And every workaround — every phone call, substitution, or counselling session — represents time and emotional labour that pharmacy teams are rarely resourced or recognised for.
A worldwide issue
The WPC identifies a long list of drivers behind the escalating crisis: shortages of raw materials, manufacturing failures, spikes in demand, labour constraints, transport bottlenecks, regulatory delays, political instability, and pricing policies which make lowmargin generics particularly vulnerable. In recent years, supplies of several key drug classes — including ADHD medications, cancer therapies, statins, opioid analgesics, anaesthetics and antibiotics — have been repeatedly strained, leading to persistent or recurring shortages.
At the same time, demand for high-profile drugs such as Mounjaro, Wegovy and Ozempic has spiked dramatically, pushing prices upward and leaving many patients — especially those who rely on these medicines to control type 2 diabetes — struggling to obtain them.
Stephen stresses the issue cannot be reduced to a single point of failure. “There is no single driver. What we see is a convergence of supplychain pressures, manufacturing constraints, demand factors and market fragility,” he says.
The data is stark. According to the Pharmaceutical Group of the European Union (PGEU), each pharmacy across the EU spends on average about 11 staff hours per week dealing with medicine shortages, and this time has tripled over the last 10 years.
In Australia, a 2024 survey commissioned by the Therapeutic Goods Administration found most patients (88.1 percent) reported finding out about shortages from a pharmacist. Some 20 percent of the Australian patients surveyed said they rationed their own medicine to make it last longer, while 17 percent received a new prescription from their GP.
These are not isolated pockets of instability; they are symptoms of a system under sustained strain.
The frontline burden
When medicines run short, community pharmacists become the navigators of uncertainty. They identify alternatives, liaise with prescribers, and counsel patients through changes they did not ask for and often do not understand.
According to Stephen, the workload impact is measurable. “Community pharmacies are absorbing a significant amount of the system’s adjustment costs, particularly in the time required to manage each shortage.”
In Germany, more than 10 percent of staff time in many pharmacies is now spent sourcing substitutes. In Canada, pharmacists report devoting up to one fifth of their working hours to managing shortages. These figures reflect a global pattern: pharmacists are absorbing the system’s fragility while trying to shield patients from its consequences.
Yet in many countries, pharmacists’ ability to respond is constrained by regulation. Even when a shortage is officially declared, substitution rules may be narrow, slow to activate, or misaligned with realworld practice.
The practical consequences are clear, says Stephen. “When substitution pathways are limited or slow to activate, the result is additional friction in the system and delays for patients.”
What needs to change
The WPC argues community pharmacies are uniquely positioned to mitigate the impact of shortages — but only if they are empowered to act. The organisation outlines several reforms which could strengthen pharmacy’s role and reduce patient harm. These include:
- Enabling flexible substitution: allowing pharmacists to substitute brands, strengths, formulations, or even therapeutic alternatives within clear national protocols.
- Improving two-way digital communicationbetween prescribers and pharmacists.
- Resourcing the pharmacy network to recognise thetime and expertise required to manage shortages.
- Temporarily adjusting supply quantities during acute shortages to prevent stockpiling.
- Supporting pharmacy compounding when commercial products are unavailable.
- Investing in realtime monitoring systems, such asSpain’s CisMED, to anticipate demand and track shortages.
These measures, the WPC argues, would not eliminate shortages — no single country can solve a global supply problem — but they would reduce the burden on patients and the profession.
Supply chain woes
Beyond pharmacyspecific measures, the WPC calls for broader reforms to stabilise the medicines supply chain. These include regularly reviewing pricing and reimbursement to ensure essential medicines remain viable for manufacturers to produce — and maintaining strong national distribution networks capable of equitable stock allocation during shortages.
“But stabilising supply will require coordinated action across regulators, manufacturers and distributors. No individual sector can resolve this independently,” Stephen says.
A global challenge
The WPC’s position reflects a growing international consensus: medicine shortages are not temporary disruptions but a structural reality. They require coordinated action across borders, sectors, and professions.
For community pharmacists, the crisis has highlighted both their vulnerability and their value. They are the ones who absorb patient anxiety, troubleshoot supply gaps, and maintain continuity of care when the system falters. Their adaptability has kept countless treatment plans on track — but resilience alone is not a sustainable strategy.
As the world grapples with increasingly fragile supply chains, the role of community pharmacy has never been more critical. The shelves may not always be full, but pharmacists continue to fill the gaps with expertise, compassion, and unwavering commitment to patient care.
