Shortage-proneness
Which medicines are most prone to shortages?
Shortages are not random. They cluster in old, widely used generics that many companies make and sell on price, with ingredients made mainly in China or India. We score 2,622 medicines on those traits every week, and test the score against Canada's shortage history.
Shortage-prone, but not short anywhere today
Medicines that score highest but are not on the shortage list of any of the 16 countries we track: the watch list.
| Medicine | Score | US makers | Ingredient makers (China + India share) | UK concessions, 12m | US recalls, 12m | EU critical | Short now (countries) |
|---|---|---|---|---|---|---|---|
| Ibuprofen | High · 99 | 35 | 11 (82%) | 2 | 1 | 0 | |
| Ibuprofen | High · 99 | 35 | 11 (82%) | 2 | 1 | 0 | |
| Hydrocortisone | High · 99 | 26 | 14 (57%) | 10 | 1 | 0 | |
| Hydrocortisone | High · 99 | 26 | 14 (57%) | 10 | 1 | 0 | |
| Hydrocortisone | High · 99 | 26 | 14 (57%) | 10 | 1 | 0 | |
| Hydrocortisone | High · 99 | 26 | 14 (57%) | 10 | 1 | 0 | |
| Hydrocortisone | High · 99 | 26 | 14 (57%) | 10 | 1 | 0 | |
| Hydrocortisone | High · 99 | 26 | 14 (57%) | 10 | 1 | 0 | |
| Budesonide | High · 98 | 21 | 21 (52%) | 1 | 1 | 0 | |
| Prednisolone | High · 97 | 19 | 10 (70%) | 1 | 2 | 0 | |
| Prednisolone | High · 97 | 19 | 10 (70%) | 1 | 2 | 0 | |
| Prednisolone | High · 97 | 19 | 10 (70%) | 1 | 2 | 0 | |
| Prednisolone | High · 97 | 19 | 10 (70%) | 1 | 2 | 0 | |
| Prednisolone | High · 97 | 19 | 10 (70%) | 1 | 2 | 0 | |
| Prednisolone | High · 97 | 19 | 10 (70%) | 1 | 2 | 0 | |
| Prednisolone | High · 97 | 19 | 10 (70%) | 1 | 2 | 0 | |
| Dexamethasone | High · 97 | 24 | 11 (55%) | 7 | 1 | 0 | |
| Dexamethasone | High · 97 | 24 | 11 (55%) | 7 | 1 | 0 | |
| Dexamethasone | High · 97 | 24 | 11 (55%) | 7 | 1 | 0 | |
| Dexamethasone | High · 97 | 24 | 11 (55%) | 7 | 1 | 0 | |
| Dexamethasone | High · 97 | 24 | 11 (55%) | 7 | 1 | 0 | |
| Dexamethasone | High · 97 | 24 | 11 (55%) | 7 | 1 | 0 | |
| Naproxen | High · 96 | 26 | 6 (83%) | 1 | 1 | 0 | |
| Naproxen | High · 96 | 26 | 6 (83%) | 1 | 1 | 0 | |
| Mometasone | High · 95 | 14 | 23 (48%) | 12 | – | 0 | |
| Betamethasone | High · 95 | 19 | 14 (43%) | 8 | – | 0 | |
| Betamethasone | High · 95 | 19 | 14 (43%) | 8 | – | 0 | |
| Betamethasone | High · 95 | 19 | 14 (43%) | 8 | – | 0 | |
| Betamethasone | High · 95 | 19 | 14 (43%) | 8 | – | 0 | |
| Betamethasone | High · 95 | 19 | 14 (43%) | 8 | – | 0 | |
| Betamethasone | High · 95 | 19 | 14 (43%) | 8 | – | 0 | |
| Lidocaine | Elevated · 94 | 45 | 13 (62%) | 0 | 7 | 0 | |
| Lidocaine | Elevated · 94 | 45 | 13 (62%) | 0 | 7 | 0 | |
| Lidocaine | Elevated · 94 | 45 | 13 (62%) | 0 | 7 | 0 | |
| Fluticasone | Elevated · 94 | 13 | 21 (43%) | 5 | – | 0 | |
| Fluticasone | Elevated · 94 | 13 | 21 (43%) | 5 | – | 0 | |
| Fluticasone furoate | Elevated · 94 | 13 | 21 (43%) | 5 | – | 0 | |
| Fluticasone furoate | Elevated · 94 | 13 | 21 (43%) | 5 | – | 0 | |
| Clonidine | Elevated · 94 | 26 | 6 (67%) | 3 | 3 | 0 | |
| Timolol | Elevated · 93 | 19 | 11 (46%) | 11 | 0 | 0 |
Most shortage-prone among medicines short today
| Medicine | Score | US makers | Ingredient makers (China + India share) | UK concessions, 12m | US recalls, 12m | EU critical | Short now (countries) |
|---|---|---|---|---|---|---|---|
| Olanzapine | High · 100 | 24 | 20 (90%) | 3 | 1 | Yes | 13 |
| Esomeprazole | High · 100 | 29 | 32 (88%) | 11 | 0 | Yes | 9 |
| Hydrocortisone | High · 100 | 26 | 14 (57%) | 10 | 1 | Yes | 4 |
| Famotidine | High · 100 | 38 | 16 (88%) | 7 | 2 | 4 | |
| Rosuvastatin | High · 100 | 20 | 35 (83%) | 6 | 1 | 11 | |
| Sertraline | High · 100 | 20 | 18 (94%) | 6 | 1 | 11 | |
| Prednisolone | High · 100 | 19 | 10 (70%) | 1 | 2 | Yes | 2 |
| Aripiprazole | High · 100 | 24 | 23 (78%) | 11 | 1 | 9 | |
| Pregabalin | High · 100 | 27 | 34 (94%) | 8 | – | 11 | |
| Pregabalin | High · 100 | 27 | 34 (94%) | 8 | – | 1 | |
| Levetiracetam | High · 100 | 48 | 32 (97%) | 10 | 0 | 9 | |
| Metformin | High · 100 | 36 | 26 (85%) | 7 | 0 | 9 | |
| Lacosamide | High · 100 | 30 | 26 (96%) | 8 | 1 | 6 | |
| Paracetamol | High · 100 | 18 | 13 (69%) | 4 | 0 | Yes | 9 |
| Estradiol | High · 99 | 31 | 14 (64%) | 8 | 2 | 11 | |
| Valproic Acid | High · 99 | 28 | 9 (56%) | 1 | 1 | Yes | 10 |
| Duloxetine | High · 99 | 18 | 29 (69%) | 7 | 9 | 12 | |
| Venlafaxine | High · 99 | 26 | 30 (80%) | 10 | 0 | 10 | |
| Aciclovir | High · 99 | 26 | 13 (62%) | 6 | – | Yes | 6 |
| Carbamazepine | High · 99 | 24 | 15 (53%) | 1 | 0 | Yes | 5 |
| Lamotrigine | High · 99 | 26 | 20 (85%) | 9 | – | 9 | |
| Fenofibrate | High · 99 | 27 | 16 (75%) | 9 | 1 | 2 | |
| Ibuprofen | High · 99 | 35 | 11 (82%) | 2 | 1 | 8 | |
| Ibuprofen | High · 99 | 35 | 11 (82%) | 2 | 1 | 1 | |
| Ibuprofen | High · 99 | 35 | 11 (82%) | 2 | 1 | 1 | |
| Gabapentin | High · 99 | 28 | 23 (78%) | 7 | 0 | 10 | |
| Gabapentin | High · 99 | 28 | 23 (78%) | 7 | 0 | 1 | |
| Rivaroxaban | High · 99 | 23 | 61 (84%) | 6 | – | 14 | |
| Atorvastatin | High · 99 | 21 | 26 (85%) | 6 | 0 | 11 | |
| Hydrocortisone | High · 99 | 26 | 14 (57%) | 10 | 1 | 2 | |
| Hydrocortisone | High · 99 | 26 | 14 (57%) | 10 | 1 | 1 | |
| Valsartan | High · 99 | 20 | 28 (89%) | 6 | 1 | 6 | |
| Dabigatran Etexilate | High · 98 | 9 | 17 (82%) | 3 | 5 | Yes | 10 |
| Tadalafil | High · 98 | 29 | 24 (88%) | 3 | – | 11 | |
| Amiodarone | High · 98 | 16 | 11 (55%) | 8 | 1 | Yes | 5 |
| Budesonide | High · 98 | 21 | 21 (52%) | 1 | 1 | 5 | |
| Budesonide | High · 98 | 21 | 21 (52%) | 1 | 1 | 1 | |
| Budesonide | High · 98 | 21 | 21 (52%) | 1 | 1 | 4 | |
| Lidocaine | High · 98 | 45 | 13 (62%) | 0 | 7 | Yes | 2 |
| Lansoprazole | High · 98 | 16 | 20 (75%) | 12 | – | 8 |
Does it work?
Health Canada, every marketed product: among products with no shortage reported in 2023–24, the share that reported one in 2025–26, by score quintile (767 medicines). Spearman correlation 0.368; with the share of products that had a shortage lasting 180 days or more: 0.406. Canada is left out when the weights are fitted, so this is an out-of-sample check. The scores use today's data, so it is a back-test, not a live forecast; we log the score every week to run a true forward test.
How the score works
Each medicine (active ingredient) is ranked on eight public measures. Each measure is weighted by how strongly it tracks the number of countries (Canada excluded) where the medicine is short today; measures that do not help get no weight. The weighted ranks are averaged and the result is ranked again: a score of 90 means more shortage-prone than 90% of the medicines we score. High is the top 5%, Elevated the next 15%, Moderate the middle 30%, Low the rest. Weights are refitted every week.
What we got wrong first. Our first version assumed that medicines with few makers are most at risk. Tested on Canada's history it ranked medicines backwards, so we dropped it. Few makers still matters for impact: when a single-source medicine is short there may be no alternative. Medicine pages show the number of approved makers separately for that reason.
Not a forecast, not medical advice and not investment advice.
Current weights
| Measure | Weight |
|---|---|
| US approved makers (more = higher) | 23% |
| Certified ingredient makers (more = higher) | 20% |
| Prescription volume in England | 14% |
| Months on England's price-concession list | 14% |
| On the EU list of critical medicines | 13% |
| Share of ingredient makers in China or India | 9% |
| US recalls in 12 months | 7% |
| US price change in 12 months | 0% |
UK price concessions per month
Packs granted a price concession in England: the government pays pharmacies above the tariff because they cannot buy at it. A national gauge of generic supply stress.
Sources: FDA Drugs@FDA and enforcement reports via openFDA (CC0); FDA Import Alert 66-40; CMS NADAC; EDQM Certification database, used with credit; the EDQM/Council of Europe bears no liability for any consequence arising from such use. EMA Union list of critical medicines; UK price concessions (DHSC) as published by Community Pharmacy England (counts only); NHSBSA English Prescribing Data (OGL v3.0); CMS Medicare Part D; Health Canada Drug Shortages Canada and Drug Product Database (back-test). Updated weekly.