At 2:17 a.m., the pharmacy line at a large Midwest ER blinked red,  the final vial of epinephrine was gone.
Moments later, a courier from a compounding partner arrived with a small, chilled container. That’s how many hospitals across America are managing what’s quietly become a chronic condition in healthcare: drug shortages.

According to the ASHP and FDA, more than 320 drugs remain on active shortage lists in 2025,  the highest total in a decade. Sterile injectables, anesthetics, and oncology agents top the chart.

Why Shortages Are Lasting Longer

Drug shortages aren’t random.
They stem from a mix of aging manufacturing plants, raw-material scarcity, and increasing demand for injectables post-COVID.
The average shortage duration has risen to 13 months (FDA Drug Shortages Quarterly Update, Q2 2025).
Hospitals can’t afford to wait,  they need structured backup plans built around 503B-aligned compounding partners.

Step 1,  Map Critical Inventory and Impact Tiers

Every institution should maintain an updated “criticality matrix”:

• Tier 1: Life-saving injectables (epinephrine, fentanyl, atropine)
  
• Tier 2: Therapeutic continuity meds (oncology, IV nutrition)
  
• Tier 3: Operational convenience items (saline flushes, contrast agents)
  

Align these tiers with potential substitutions and alternative formulations from trusted compounding providers.

(See AllMedRx’s guide on Compounded GLP-1s in 2025 for an example of how supply alignment affects care continuity.)

Step 2, Build Dual Sourcing with 503B Compounding Partners

OutSourceWoRx and similar 503B-aligned facilities help fill supply gaps by preparing sterile medications under cGMP processes with third-party validation for sterility and potency.

Hospitals should audit their partners for:

• Independent testing (CoAs & batch records)
  
• Environmental monitoring logs
  
• Cold-chain transport data
  
• Transparent corrective-action plans
  

Step 3,  Integrate Documentation into Pharmacy Workflows

A modern hospital pharmacy is a data engine.
Compounding documentation, Certificates of Analysis, sterility results, and temperature logs  should feed directly into the P&T Committee’s approval cycle and EMR audit trail. Doing so reduces investigation time and enhances regulatory readiness.

(See Capital Worx’s Compliance as Alpha for why transparency is a business moat.)

Step 4, Case Snapshot — From Crisis to Continuity

“We used to track shortages on a whiteboard,” says a pharmacy director at a Florida hospital.
“Now we track them through compounding orders, and we haven’t missed a dose in 14 months.”

That shift illustrates how pharmacy leadership is turning procurement into a resilience strategy.

Step 5,  Plan for Audit and Accreditation

Before each Joint Commission survey or state inspection, pharmacies should validate that all compounding suppliers provide:

• Traceable lot numbers
  
• Chain-of-custody evidence
  
• CoAs matching each shipment
  

Consistency in documentation often decides whether a hospital passes with commendation or correction.

Final Takeaway

Drug shortages aren’t a temporary crisis,  they’re a permanent operational variable.
Hospitals that invest in strong compounding relationships and digital documentation systems achieve something priceless: predictability in unpredictable times.

OutSourceWoRx continues to partner with providers nationwide to deliver sterile, tested, and traceable medications that support continuity of care and clinical trust