Managing drug shortages: Resource utilization and strategies to mitigate patient impact in a large multicenter health system

Abstract Purpose This report evaluates the structure, impact, and resource demands of a Proactive Drug Shortage Committee (PDSC) within a large, multicenter health system, highlighting its response to the 2024 intravenous fluid (IVF) shortage and associated financial and labor burdens. Summary The PDSC model described is implemented across an 11-hospital health system and consists of pharmacy leaders, buyers, informatics specialists, and clinical and operational staff. Meeting weekly, the committee monitors shortages utilizing real-time data to influence mitigation strategies rooted in coordination, collaboration, and communication. The 2024 natural disaster Hurricane Helene resulted in a widespread IVF shortage during which the PDSC implemented conservation protocols, electronic health record alerts, clinical restrictions, and internal compounding. These efforts led to a 33% reduction of IVF usage within 25 days of the event. Time assessments revealed significant increases in shortage-related FTE requirements during crisis periods, with roles such as clinical pharmacists and data analysts experiencing up to 400% increases. Financially, the health system shifted from 8.45% under budget in September 2024 to 8.55% over budget during the peak shortage months due to overtime, compounding resources, and alternative sourcing. Conclusion A PSDC is an integral part of a health system, with the model demonstrated to be effective in enabling a scalable, multidisciplinary approach to successfully managing drug shortages. Its proactive nature, use of real-time data, and cross-functional collaboration are essential to preserving patient care and operational continuity. Crisis-level shortages demand heightened labor and financial investment, reinforcing the need for dedicated, system-wide preparedness and response mechanisms.