Integrating Demand Forecasting, Real-Time Inventory Visibility, And Equitable Allocation Models to Mitigate Medication Shortages in U.S. Healthcare Supply Chains

Medication shortages in the United States are not just occasional supply failures; they are ongoing disruptions to the health system caused by poor demand visibility, limited upstream transparency, fragile manufacturing economics, and fragmented coordination. Public data illustrates the problem's extent. ASHP reported 223 active drug shortages recently, down from the 323 at the peak in early 2024 but still rising quarter by quarter. The FDA's 2024 report to Congress revealed 15 new shortages in 2024 and 113 ongoing shortages as of December 2024, 2024. Independent analysis of data from 2018-2023 shows shortages increased from 313 in January 2020 to 350 in December 2023, with injectable medicines being most affected. This article proposes a decision-support framework that combines three often-separated components: probabilistic demand forecasting, real-time inventory visibility, and equity-based allocation of scarce medicines. Its contribution focuses on methodology rather than purely on empirical evidence, outlining the minimum data requirements, mathematical formulation, optimisation logic, governance conditions, and evaluation metrics needed to shift shortage management from reactive substitution to proactive resilience. The framework aims to serve rural hospitals, safety-net providers, pharmacies, and high-acuity services where drug shortages can quickly cause treatment delays, urgent procurement, and unfair access. The paper concludes that an effective shortage mitigation system must integrate forecast calibration, facility-level risk scoring, and transparent allocation rules; otherwise, it is merely a dashboard with enhanced visuals.

medication shortages; pharmaceutical supply chain; demand forecasting; inventory visibility

1. American Society of Health-System Pharmacists (ASHP). Drug Shortages Statistics. Available at: https://www.ashp.org/drug-shortages/shortage-resources/drug-shortages-statistics. Accessed 15 June 2026. [Google Scholar] [Crossref]

2. American Society of Health-System Pharmacists (ASHP). National Drug Shortages: 2024 Drug Shortages Survey / Report. 2025. Available at: https://www.ashp.org/-/media/assets/drug-shortages/docs/2024/2024-Drug-Shortages-Survey.pdf. Accessed 15 June 2026. [Google Scholar] [Crossref]

3. U.S. Food and Drug Administration (FDA). Drug Shortages. Available at: https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages. Accessed 15 June 2026. [Google Scholar] [Crossref]

4. U.S. Food and Drug Administration (FDA). Drug Shortages: Report to Congress, Calendar Year 2024. Available at: https://www.fda.gov/media/189325/download. Accessed 15 June 2026. [Google Scholar] [Crossref]

5. U.S. Government Accountability Office (GAO). Drug Shortages: HHS Should Implement a Mechanism to Coordinate Its Activities. GAO-25-107110. 9 April 2025. [Google Scholar] [Crossref]

6. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Policy Considerations to Prevent Drug Shortages and Mitigate Supply Chain Vulnerabilities in the United States. 2024. [Google Scholar] [Crossref]

7. U.S. Food and Drug Administration. Supply Chain News, Reports and Publications. Includes HHS 2025-2028 Draft Action Plan for Addressing Shortages of Medical Products and Critical Foods. Available at: https://www.fda.gov/emergency-preparedness-and-response/supply-chain/supply-chain-news-reports-and-publications. Accessed 15 June 2026. [Google Scholar] [Crossref]

8. McGeeney JD, et al. Analysis of Drug Shortages, 2018-2023. NCBI Bookshelf. 2025. [Google Scholar] [Crossref]

9. IQVIA Institute for Human Data Science. Drug Shortages in the U.S. 2023. 2023. [Google Scholar] [Crossref]

10. Office of the Assistant Secretary for Preparedness and Response (ASPR). National Strategy for a Resilient Public Health Supply Chain. U.S. Department of Health and Human Services. 2021. [Google Scholar] [Crossref]

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