Getting a text or hearing at the pharmacy counter that your prescription wasn’t able to be filled usually comes with a new diagnosis: a pit in your stomach. Maybe it’s due to a shortage, or maybe there’s a logistical hiccup that explains it. Either way, you’re left wondering what to do without your medication.
So, what do you do in this situation? We asked experts to break down why pharmacies run out of medications we need, and how you can work with your pharmacist to find a solution if you find yourself in a bind.
What causes medication shortages?
Medication shortages can happen for a variety of reasons. For example, certain ADHD
medications have faced ongoing supply challenges that date back to 2022. In some cases, manufacturers stopped producing generic versions of ADHD medications, which increased demand for other products and strained the supply chain, according to Brigid Groves, PharmD, MS, the vice president of Professional Affairs at the American Pharmacists Association.
Other times, shortages stem from manufacturing problems, difficulty sourcing raw materials, or even natural disasters. Dr. Groves points out that when hurricanes hit parts of the Carolinas, they disrupted facilities that produced IV saline bags for injectable medications, creating ripple effects in hospitals nationwide.
What should you do if your medicine is unavailable?
When you can’t get a medication, Dr. Groves says your first question for the pharmacist should be a simple one: “Is this a shortage, or just a delay?”
A short-term delay usually means that your pharmacy doesn’t have the medication in stock that day, but can order it from another wholesaler, often within 24 hours, says Kristen Riddle, PharmD, the president of the National Community Pharmacists Association. If it’s a simple delay, ask your pharmacist questions like:
- “When do you expect it to arrive?”
- “Can I pick it up tomorrow?”
- “Will you notify me when it’s ready?”
But a true shortage means the medication may be difficult to source regionally or even nationwide, with no clear timeline for restocking. Dr. Riddle notes that pharmacists will typically explain which situation you’re facing, but if they don’t, it’s absolutely appropriate to ask for more information and guidance.
Should you call your doctor if your medication is not in stock?
“I would recommend that the patient start with their pharmacist,” Dr. Groves says. Pharmacists are trained in medication equivalency and safety. They also know what’s actually available in real time: something prescribers often aren’t privy to.
In some states, pharmacists may be able to recommend or coordinate a switch to a similar medication in the same class. For example, if a blood pressure medication is unavailable, another drug in the same class may work just as well, Dr. Groves explains. If an antibiotic is out of stock, your pharmacist can quickly collaborate with your provider to choose an effective substitute.
Dr. Groves and Dr. Riddle both emphasize that your pharmacist should be your first stop, but there are two main scenarios where you may need to call your doctor’s office:
- Prior authorization issues: If your insurance requires additional paperwork before covering the medication, your doctor may need to submit documentation. Sometimes the pharmacist initiates the process, but following up can help move it along.
- True nationwide shortage with no immediate alternative: If the medication simply can’t be sourced and you need a new treatment plan, your prescriber will need to weigh in.
How do you know if you’re facing an urgent health situation without your medication?
Some medications can’t be delayed or stopped abruptly, Dr. Groves explains. These include:
- Insulin and other diabetes medications
- Certain heart medications
- Anti-seizure medications
- Some antidepressants and anti-anxiety medications
- Antibiotics that need to be started promptly
If you’re ever unsure, ask your pharmacist directly: “Is it safe for me to miss a dose?”
If you’re at risk of running out of your medication, pharmacists will often call nearby pharmacies to locate the medication or work urgently with your prescriber to find a solution. “Our ultimate goal is that the patient is taken care of,” Dr. Riddle says.
What can you do to prepare for a potential medication shortage?
While you can’t control national supply chains, there are ways to reduce your chances of being caught off guard.
Stay on top of refills.
“It’s really important for patients and caregivers to make sure that they’re having an active role in their care and know when their refills are going to be due so that they can help to stay on top of that and prevent any gaps in medication therapy,” Dr. Groves says.
If possible, try signing up for an auto-refill program. “Many pharmacies, both chain and independent, offer refill programs where you agree that you want your prescription refilled automatically, and it happens behind the scenes. You get a phone call or a text message telling you it's ready and you can come in at your convenience to grab that,” Dr. Groves says.
Ask about medication synchronization.
Some pharmacies offer programs that align all your prescriptions to refill on the same day each month. This makes it easier for the pharmacy to plan inventory, and easier for you to stay organized, according to Dr. Groves.
Communicate special needs.
If you need a specific manufacturer due to allergies or other needs, let your pharmacy know. That gives them time to source the correct product, Dr. Groves says.
Build a relationship.
Especially at locally owned pharmacies, having an established relationship can make a big difference. “As pharmacists, we want to help the patient,” Dr. Riddle says. “We want to make sure they have the medication they need.”
The bottom line
Medication hiccups are frustrating, but they’re usually manageable with open communication and advance planning. If your pharmacy is out of your prescription, follow these steps:
1. Ask why. Is it a simple delay or a true shortage?
2. Ask when it will be available.
3. Let your pharmacist coordinate with your doctor first.
4. Never stop critical medications without guidance.
5. Be proactive with refills and pharmacy programs.
