Hospitals across the U.S. are still facing serious drug shortages—and it’s not letting up anytime soon.

According to Bluesight’s 2025 Hospital Pharmacy Operations Report, 75% of hospital pharmacy professionals say drug shortages are their biggest concern. This marks the sixth year in a row that shortages have topped the list.

Lauren Forni, Senior Director of Clinical Strategy at Bluesight, says shortages are a major strain. Some involve essential, life-saving medications, and the causes vary—from supply chain issues and raw material delays to surging demand that manufacturers haven’t been able to keep up with.

In Q1 2025, there were 270 active drug shortages, according to the American Society of Health-System Pharmacists (ASHP). That’s slightly better than the record high of 323 in early 2024, but still alarming.

Hospitals are also dealing with IV fluid shortages after Hurricane Helene caused flooding at a key North Carolina production plant.

Staffing Is the Other Big Pain Point

Beyond medications, 55% of hospital pharmacies report staffing shortages as another top operational challenge. As Forni notes, “The workload never decreases. It only increases.”

This has led some health systems to centralize pharmacy operations, streamlining work across locations to offset the staffing gaps.

Rising Scrutiny Around 340B

Many hospital pharmacies are also preparing for increased oversight of the 340B Drug Pricing Program, which lets hospitals buy some outpatient drugs at reduced prices. Critics argue the program has expanded too far, but health systems defend it as essential for delivering care in underserved areas.

Without it, Forni says, hospitals would struggle even more with medication costs: “The 340B program helps offset a lot of that financial burden.”

Drug Diversion & the Tech Catch-Up

Two-thirds of pharmacy professionals report drug diversion incidents in the past year—meaning medications meant for patients were taken by staff or others.

While inventory-tracking software is becoming more common, some bad actors still find ways to work around detection. Hospitals are turning to digital tools to get ahead of these issues, streamline purchasing, and reduce manual processes.

Still, Forni points out, many hospital pharmacies are just now starting to adopt these tools, and the process of improving transparency and efficiency is slow.

Cost Pressure Isn’t Going Anywhere

With tight budgets and rising drug costs, 95% of hospital pharmacies say they’re actively trying to streamline purchasing and manage supply chain risk. But Forni says the process remains messy: “It’s not very clear and transparent on how to optimize that. There’s a lot of manual work.”

Hospital pharmacy leaders are being asked to do more with less—while navigating complex supply challenges, regulatory changes, and workforce gaps. It’s no wonder drug shortages remain their number one concern.

Source: Chief Healthcare Executive, Hospital pharmacies are worried about drug shortages, staffing and federal oversight by Ron Southwick.