Access · Shortages

Second pass at: Hoarding and why it makes a shortage worse

Access › Shortages FDA compounding shortage

g.tanakaTL3Regular8 Oct 2024#1

Second pass at: Hoarding and why it makes a shortage worse Writing it up because I had to work it out twice and would rather nobody else did.

Documenting an access outcome, dated, because everything in this category expires.

As of January 2026, in my region, the position is as described below. I have linked the primary source rather than a summary of it, because the summaries are consistently a year behind.

If anyone can confirm or contradict this for their own region, please date your answer. An undated claim in this category is worse than no claim.

1 like 22mo

excursion_checkTL3Regular8 Oct 2024 · edited#2

Both are useful and different. The notice tells you the national position; the account tells you what is happening on the ground.

0 likes 22mo

k.haddadTL28 Oct 2024#3

excursion_check, post #2: Both are useful and different. The notice tells you the national position; the account tells you what is happening on the ground. Go to post

This settles it for me, at least until somebody posts a reason it should not.

14 likes in reply to #2 22mo

c.niemelTL3Regular8 Oct 2024#4

Taking the opening post at face value and following it one step further.

Regional differences during a shortage are large, and a supply position in one country says nothing about another.

I would want a second opinion before relying on that.

5 likes 22mo

t.verhoevenTL28 Oct 2024#5

Anyone reporting availability should say the region and the date, because both determine whether the report is usable.

2 likes 22mo

l.chevalierTL3Regular8 Oct 2024#6

Shortage-driven price movement is real and is a separate question from availability.

0 likes 22mo

s.vanheckeTL28 Oct 2024#7

l.chevalier, post #6: Shortage-driven price movement is real and is a separate question from availability. Go to post

Post #5 put the caveat in the right place and I want to underline it.

Dose hold versus tapering: if a temporary shortage forces a gap, holding your dose and resuming when supply returns is different from gradually tapering. The two are different decisions.

Second-hand, so weight it accordingly.

20 likes in reply to #6 22mo

taper_tableTL3Regular8 Oct 2024#8

Supply interruptions: official shortage notices are published by regulatory agencies. That is the correct primary source rather than pharmacy rumors or forum discussion.

Scoping that to what I have actually seen rather than what I have read.

9 likes 22mo

b.nilsenTL28 Oct 2024 · edited#9

Coming back to post #5, because the follow-up matters more than the original answer.

Where a shortage forces a gap, the pharmacokinetics mean a missed week is a perturbation rather than a reset, which is worth knowing.

0 likes 22mo

n.petrovTL28 Oct 2024#10

Post #9 is right about the mechanism and I think understates the practical bit.

Stockpiling in response to a shortage worsens it, which is true and is a poor argument to make to somebody who has run out.

Posting it because the silence on this was starting to look like agreement.

21 likes 22mo

endo_fellow_rkTL3Endocrinology fellow9 Oct 2024#11

n.petrov, post #10: Post #9 is right about the mechanism and I think understates the practical bit. Stockpiling in response to a shortage worsens it, which is true and is a poor argument to make to somebody who has run out. Posting it because the silence on this was starting to look like agreement. Go to post

The published shortage register maintained by the national regulator is the authoritative source here, and it is updated far more often than any thread.

7 likes in reply to #10 22mo

j.vogelTL29 Oct 2024#12

k.haddad, post #3: This settles it for me, at least until somebody posts a reason it should not. Go to post

Shortage status determines what compounding is permitted in some jurisdictions, which links two questions that otherwise seem unrelated.

17 likes in reply to #3 22mo

TL4_HalvorsenTL4Leader · Journal club9 Oct 2024#13

Post #10 is the version of this I will quote in future. One addition.

Compounding during shortages: some jurisdictions allow pharmacy compounding when a marketed product is in shortage. That permission is jurisdiction-specific and time-limited (usually for the duration of the shortage).

Small point, but it is the one that usually catches people.

0 likes 22mo

h.lindqvistTL29 Oct 2024#14

Where I part company with post #12, and it is a narrow parting.

Shortage predictions: regulators and suppliers issue shortage alerts before they become acute. Checking the regulatory website for shortages gives you advance notice.

Worth one more sentence than it usually gets.

1 like 22mo

s.leclercTL4 Moderator9 Oct 2024 · edited#15

TL4_Halvorsen, post #13: Post #10 is the version of this I will quote in future. One addition. Compounding during shortages: some jurisdictions allow pharmacy compounding when a marketed product is in shortage. That permission is jurisdiction-specific and time-limited (usually for the duration of the shortage). Small point, but it is the one that usually… Go to post

The arithmetic in post #14 is right; the assumption feeding it is the part to check.

Reports that a pharmacy has stock are the least durable information on the site and are still worth posting with a date.

On reflection I would soften that slightly.

11 likes in reply to #13 22mo

a.wikstromTL29 Oct 2024#16

Where an alternative within the class is available, the comparison is a clinical one and the doses are not equivalent.

The evidence for this is thinner than the way I have phrased it suggests.

24 likes 22mo

chromatogramTL4Analytical chemist9 Oct 2024#17

Manufacturer allocation decisions during a shortage are commercial and are rarely explained, which is frustrating and is not evidence of anything.

A modest claim, modestly supported.

0 likes 22mo

t.dumitruTL29 Oct 2024#18

Quietly grateful for the plain phrasing. Not every thread gets that.

3 likes 22mo

c.rasmussenTL29 Oct 2024#19

Planning around a known shortage window is easier than reacting to one, and the notices give advance warning more often than people expect.

I have changed my mind on this once already, so take it as current rather than settled.

16 likes 22mo

j.nascimentoTL29 Oct 2024#20

b.nilsen, post #9: Coming back to post #5, because the follow-up matters more than the original answer. Where a shortage forces a gap, the pharmacokinetics mean a missed week is a perturbation rather than a reset, which is worth knowing. Go to post

Everything in post #16 holds. The case it does not cover is the one I have.

Where an alternative within the class is available, the comparison is a clinical one and the doses are not equivalent.

If it helps: the failure mode here is usually boring rather than dramatic.

32 likes in reply to #9 22mo

c.amankwahTL29 Oct 2024 · edited#21

Managing an unplanned gap: if a shortage causes a gap in treatment, the questions are how long the gap will be and how that affects your condition. Discussing with your clinician is prudent if the gap is weeks or longer.

The conclusion is tentative; the arithmetic underneath it is not.

11 likes in reply to #10 22mo

TL4_HalvorsenTL4Leader · Journal club9 Oct 2024#22

l.chevalier, post #6: Shortage-driven price movement is real and is a separate question from availability. Go to post

Building on post #21 rather than restating it.

Shortage-driven price movement is real and is a separate question from availability.

The step people skip is the one I have spelled out.

3 likes in reply to #6 22mo

an.ibarraTL29 Oct 2024#23

Everything in post #21 holds. The case it does not cover is the one I have.

A shortage of one presentation is not a shortage of all of them, and the published notices are specific about which.

0 likes 22mo

formulary_notesTL3Regular9 Oct 2024#24

Pharmacy-level availability varies enormously during a shortage, so two honest accounts from the same city can be opposite.

32 likes 22mo

y.adebayoTL29 Oct 2024#25

Where I part company with post #21, and it is a narrow parting.

Switching presentation or strength during a shortage is a prescribing decision rather than a substitution anybody should improvise.

The disagreement above is smaller than it looks once the terms are fixed.

16 likes 22mo

ms_hollowayTL4Mass spectrometrist9 Oct 2024#26

Fair, and the limits you put on it are the part I will remember.

6 likes in reply to #9 22mo

r.ekstromTL29 Oct 2024#27

Reports that a pharmacy has stock are the least durable information on the site and are still worth posting with a date.

1 like 22mo

endo_fellow_rkTL3Endocrinology fellow9 Oct 2024#28

Pharmacy-level availability varies enormously during a shortage, so two honest accounts from the same city can be opposite.

I would rather say I do not know than round it up to an answer.

0 likes 22mo

sa.rasmussenTL210 Oct 2024#29

Worth separating two things that post #25 runs together.

International supply chains: a shortage in one country does not mean shortage in another. That is why ordering from multiple suppliers before a shortage gets bad is prudent if you can.

3 likes 22mo

i.aranda_esTL2Translator · ES10 Oct 2024#30

excursion_check, post #2: Both are useful and different. The notice tells you the national position; the account tells you what is happening on the ground. Go to post

That is what the documentation says. What happens in practice is usually close.

0 likes in reply to #2 22mo

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