When your prescription runs out and the pharmacy says they don’t have it-again-you’re not alone. In 2025, more than 250 different medications were in short supply across the U.S. and Australia, from common antibiotics to life-saving insulin and cancer drugs. These aren’t temporary hiccups. Many shortages have lasted over two years. You might feel stuck, scared, or even angry. But there are real, actionable steps you can take right now to keep your treatment on track without risking your health.
Know What’s Actually Short
Not every drug shortage is the same. Some affect only one brand, while others hit every version of the same active ingredient. For example, Semglee (a biosimilar insulin) ran out in early 2025, but Lantus-the original insulin glargine-was still available. That’s because Semglee and Lantus are considered interchangeable by the FDA. You don’t need a new prescription to switch between them. But if your doctor prescribed Toujeo or Tresiba instead, those are different drugs with different dosing. Switching those requires a new script.Check the FDA Drug Shortage Database first. It’s free, updated daily, and lists exactly which drugs are short, why, and if there are approved alternatives. Don’t rely on pharmacy staff alone-they may not know the latest updates. Type in your medication name. If it’s listed, the database will tell you what other drugs can work in its place.
Don’t Guess-Talk to Your Doctor
Some patients stop taking their meds entirely during a shortage. That’s dangerous. Others try to stretch doses or switch to over-the-counter options. Neither is safe. The right alternative isn’t always obvious. For instance, during amoxicillin shortages, some doctors switched patients to azithromycin. But azithromycin works differently. It doesn’t treat the same infections as well, and overusing it increases antibiotic resistance.Bring up the shortage at your next appointment-even if it’s not your main reason for visiting. Ask: “Is there a therapeutic equivalent?” or “Can we adjust the dose or form?” For blood pressure meds, switching from a tablet to a liquid might work. For diabetes, changing from once-daily to twice-daily insulin can help stretch supply. Your doctor has access to clinical guidelines and knows what alternatives have been tested and approved.
Use Your Pharmacist as a Resource
Pharmacists are your hidden allies in a shortage. In 2025, 89% of major pharmacy chains in the U.S. and Australia started offering free shortage navigation services. They can:- Check inventory across multiple locations-including mail-order pharmacies
- Verify if a generic or biosimilar is covered by your insurance
- Help you request an emergency supply if your state allows it
In New Jersey, pharmacists can now dispense a 30-day emergency insulin supply without a new prescription. Hawaii allows foreign-approved versions of drugs (like those from Canada or the EU) if they’re on an FDA-approved list. Ask your pharmacist: “What options do we have under state law?” They might know about local programs you didn’t even know existed.
Insurance Can Be a Hurdle-But It Doesn’t Have to Be
Blue Cross NC made changes in March 2025 to help patients during the Semglee shortage. They removed prior authorizations for Lantus on certain plans. That meant patients could get the substitute without waiting days for approval. But not all insurers did this. Many still require paperwork, even for safe, approved swaps.Call your insurer. Ask: “Is there a formulary exception for [drug name] due to shortage?” If they say no, ask for the name of the medical director and request a formal exception. Many times, they’ll approve it if you show proof of shortage from the FDA site. Keep records of every call-date, time, name, what was said. You might need it later.
Stockpiling Isn’t Just for Hospitals
Some states are preparing. California, New York, and Washington are stockpiling medical abortion drugs. Other states are hoarding insulin and chemotherapy agents. You can’t do that on your own-unless your doctor prescribes extra.If you’re on a chronic medication with a known shortage risk (like insulin, epinephrine, or certain heart drugs), ask your doctor if you can get a 90-day supply instead of 30. Many insurers allow this for maintenance meds. It’s not hoarding-it’s planning. And if you have a stable condition, some doctors will write a prescription for a backup drug to keep on hand. For example, if you take metformin and it goes short, having a prescription for sitagliptin ready can save you weeks of disruption.
When No Alternatives Exist-What Then?
Some drugs have no good substitutes. This is especially true in oncology. Between 2023 and 2025, 15 cancer drugs were in shortage, and 12 of them had no direct alternatives. For pediatric chemo, the situation is even worse-7 of those 15 were used only for children.In these cases, your medical team may need to adjust your treatment plan. Maybe you get a different drug with similar results, or your schedule changes from weekly to every other week. Sometimes, clinical trials offer access to the drug you need. Talk to your oncologist about trial options. You can also contact the drug manufacturer directly. Pfizer and Eli Lilly have hotlines for patients during shortages. They’ll tell you when production is expected to resume-and sometimes they’ll ship a small supply directly if you’re in crisis.
What Not to Do
There are dangerous myths out there. Don’t:- Buy drugs from unverified online sellers
- Split pills unless your doctor says it’s safe
- Use expired medication without consulting a pharmacist
- Stop taking your drug because you can’t refill it
A Reddit user named DiabeticDad87 spent three days calling seven pharmacies trying to find Semglee for his child. He didn’t give up. He didn’t try to order from a shady website. He called his doctor, his pharmacist, and his insurer. He found a solution. You can too.
Plan Ahead for the Next Shortage
Shortages aren’t going away. The FDA now inspects critical drug factories monthly instead of quarterly-and that’s helped reduce new shortages by 15%. But the system is still fragile. Eighty-five percent of generic drugs come from just five manufacturers. One factory shutdown can ripple across the country.Start building a personal drug shortage plan:
- Keep a list of all your meds, including generic names
- Know your insurer’s formulary rules
- Save your pharmacist’s direct line
- Set calendar reminders to check the FDA shortage list every 60 days
- Ask your doctor now: “What’s my backup plan if this drug goes short?”
The goal isn’t to panic. It’s to be prepared. When you know your options, you take back control. You don’t have to wait for someone else to fix the system. You can act today-before your next refill is due.
Lauren Warner
January 11, 2026 AT 01:16The FDA database is useless if your doctor won’t accept it. I’ve had three prescriptions denied because the insurer says 'therapeutic equivalence' doesn't mean 'covered.' No one talks about the real bottleneck: pharmacy benefit managers who control access, not the manufacturers. This isn’t about information-it’s about power.
And don’t get me started on the 'ask your pharmacist' advice. My pharmacist has 47 patients in front of me and a 20-minute window to answer my question. They’re not your personal drug detective.
Stop treating patients like we’re supposed to be resourceful. We’re supposed to be able to get our meds without playing detective, calling five people, and begging for mercy.
This article reads like a corporate PR piece disguised as public service. The system is broken. We’re just the ones getting blamed for not navigating it well enough.
steve ker
January 11, 2026 AT 10:20Why are we even talking about this like it’s a new problem
Drugs have been short for decades
Everyone just gets used to it
Now you’re mad because you can’t get your brand name pill
Grow up
George Bridges
January 12, 2026 AT 23:09I appreciate the practical steps here, especially the part about checking state-specific emergency dispensing rules. I live in Oregon and didn’t know we could get a 30-day insulin supply without a script until last month. My endocrinologist had no idea either.
It’s frustrating how much of this knowledge is siloed-pharmacists know it, but doctors don’t always pass it on, and patients are left scrambling. Maybe we need a national patient advocacy portal that aggregates these rules by state. Not another website, but something integrated into EHRs.
Also, props to DiabeticDad87. That’s the kind of persistence we need more of, not just outrage.
Faith Wright
January 13, 2026 AT 12:58Oh wow, so now we’re supposed to be pharmaceutical detectives AND insurance negotiators AND state law experts?
Let me get this straight-my life depends on a drug that’s been in shortage for 18 months, and the solution is to ‘ask your doctor’ like they have magic powers?
My doctor has 12 minutes per visit and a clipboard with 30 checkboxes. They don’t know what’s in stock at CVS, let alone if Lantus is covered under my plan’s ‘preferred tier’ this week.
And don’t even get me started on ‘stockpiling.’ I’m not a hoarder, I’m a diabetic. I don’t want to keep insulin in my garage like canned beans. I want the system to work.
Thanks for the advice, but this reads like a manual written by someone who’s never had to wait three days for a refill while their blood sugar climbs.
beth cordell
January 14, 2026 AT 20:33OMG YES this is so real 😭
I’ve been on metformin for 12 years and last month they were out for 3 weeks. I called 14 pharmacies. One had it but only 10 pills. I cried in the parking lot.
My pharmacist saved me-she called a mail-order in Colorado and got me a 90-day supply. She didn’t even charge me extra.
Also, the FDA database is legit. I use it every month now. Bookmark it. It’s your new best friend. 🙏
And to the people saying ‘just deal with it’-no. This is healthcare. Not a game. We deserve better.
Craig Wright
January 15, 2026 AT 15:33This entire piece is an indictment of American healthcare inefficiency. In the UK, we have the NHS system-centralized, standardized, and with national stockpiles of critical medicines. We do not rely on patients to become pharmacists or legal researchers.
It is unacceptable that a citizen must navigate a labyrinth of insurers, state laws, and pharmacy inventories just to obtain a prescribed life-saving drug. This is not resilience. This is negligence.
While I commend the practical advice, it is a Band-Aid on a severed artery. The solution lies in national supply chain oversight-not individual heroism.
Lelia Battle
January 16, 2026 AT 13:41There’s a quiet dignity in how people adapt when systems fail. I’ve seen elderly patients in my community trade insulin vials with neighbors because one got a shipment and another didn’t. No one reported it. No one made a fuss.
It’s not about breaking rules. It’s about survival. And yet, the system doesn’t see that. It sees compliance or noncompliance, not human beings holding each other up.
Maybe the real solution isn’t in databases or formularies, but in rebuilding trust-not just between patient and provider, but between people.
We don’t need more steps. We need more care.
Rinky Tandon
January 17, 2026 AT 18:49Let’s be real here-the entire pharmaceutical supply chain is a cartelized oligopoly with zero transparency. The FDA’s database is a performative transparency exercise while 85% of generics are sourced from 5 manufacturers in India and China with zero regulatory parity. This is structural capitalism failure, not a logistical hiccup.
Therapeutic equivalence is a legal fiction. Bioequivalence studies are conducted on healthy young males. What about elderly patients with renal impairment? Or pediatric oncology? The system is designed to fail the vulnerable.
And now you want us to ‘ask our doctor’? Your doctor is incentivized to prescribe the cheapest option, not the safest one. The conflict of interest is baked in.
Stop normalizing this. This isn’t ‘planning ahead.’ This is living under a predatory system.
Ben Kono
January 18, 2026 AT 02:39My pharmacist told me to call the manufacturer directly
I did
They mailed me 30 days of my insulin for free
no questions asked
you dont need a spreadsheet
you just need to ask
Cassie Widders
January 18, 2026 AT 20:23I’ve been on the same blood pressure med for 10 years. Last year it vanished. Took me six weeks to find a replacement that didn’t make me dizzy. My doctor didn’t even know it was gone until I told him.
Now I keep a printed list of my meds and their generic names in my wallet. I show it to every pharmacist. I check the FDA site every two months.
It’s exhausting. But I’m still here.
That’s all that matters.