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Most medicines shortages are triggered in the early stages of the supply chain and require proactive rather than reactive management, according to a new study published in Research in Social and Administrative Pharmacy.
In the scoping review, published on 25 October 2025, a team of researchers in the Netherlands analysed data from 36 studies published in English or Dutch between 2004 and 2023 from high-income countries, including the UK.
A total of 18 of these studies concerned the causes of drug shortages, while 16 studies identified “manufacturing issues” as a major cause, which included shortages of active pharmaceutical ingredients (APIs) and packaging supplies — often as a result of limited availability of products or “lack of quality” of products that were available, the researchers found.
The review’s authors noted that most interventions to respond to medicines shortages were “reactive rather than preventive” and didn’t address the root causes that occur higher up in the supply chain.
“It is crucial to focus on the causes early in the product chain, for example by performing a thorough stakeholder analysis,” the authors added.
Other factors contributing to global supply issues were poor forecasting based on “outdated prescription data”, as well as “outdated procurement policies which often result in last-minute purchases”.
The authors also expressed that there is a “lack of effective penalties for pharmaceutical companies in case of failure to supply a drug”.
Speaking at an evidence session for the House of Lords Public Services Committee on medicines security, held on 15 October 2025, Keith Ridge, former chief pharmaceutical officer for England, said that in the UK there was “no explicit government policy around the stockpiling of critical medicines”.
“Germany has six months’ supply at stockholding and manufacturer level, and France are doing something similar,” he added.
A National Pharmacy Association (NPA) analysis of government data, published on 9 October 2025, found that manufacturers had warned the government about potential medicine supply problems 28 times per week over the past five years.
Commenting on the study, Tase Oputu, chair of the Royal Pharmaceutical Society’s English Pharmacy Board, said: “This review echoes much of what our own research has found — that medicines shortages are driven by complex, global factors such as manufacturing problems, fragile supply chains and outdated procurement systems.
“Our report highlighted the same concerns, calling for earlier reporting from manufacturers, better forecasting and more resilient supply chains.
“While pharmacists are working tirelessly to support patients when shortages occur, lasting improvement depends on tackling the root causes within the supply chain and developing a UK-wide strategy to strengthen medicines security.”
