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Supply Chain Events and Risk of Drug Shortage in Canada
Araniy Santhireswaran1, Martin K H Ho1, Katherine Callaway Kim2
1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
JAMA Network Open
|June 4, 2026
Summary
Most reported supply chain events do not lead to drug shortages. Lower-selling drugs, anti-infectives, and over-the-counter medications face higher shortage risks, informing better drug supply chain policies.
Area of Science:
- Pharmaceutical Sciences
- Health Services Research
- Supply Chain Management
Background:
- Drug shortages pose a significant challenge to healthcare delivery.
- Manufacturer-reported shortages do not fully capture population-level drug availability.
- Understanding supply chain impacts on drug utilization is crucial for policy.
Purpose of the Study:
- To quantify incident drug shortages after Canadian supply chain events.
- To identify drug characteristics associated with increased shortage risk.
Main Methods:
- A matched cohort study analyzed monthly drug purchasing data (Jan 2017-Dec 2021).
- Supply chain events reported in Drug Shortages Canada were used as exposure.
- Incident shortages (≥33% purchase volume decrease) were analyzed using logistic regression.
Main Results:
- 61% of drugs were exposed to supply chain events; 11% experienced shortages.
- Drugs with lower baseline sales (<$100,000), anti-infectives, and OTC drugs had higher odds of shortage.
- Controlled drugs and those with many product variations showed higher shortage intensity.
Conclusions:
- Most reported supply chain events do not result in significant drug shortages.
- Findings suggest a need for unified shortage definitions focusing on actual supply disruptions.
- Results can inform policies to manage drug shortages and improve healthcare delivery.
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