When your prescription runs out and no pharmacy has it in stock, it’s not just inconvenient-it’s dangerous. In 2025, over 1,961 prescription drugs were in short supply across the U.S., with many of these shortages lasting over two years. Insulin, antibiotics like amoxicillin, chemotherapy drugs, and even basic pain relievers like acetaminophen injections have all hit critical lows. If you’re relying on one of these medications, you can’t wait for the system to fix itself. You need a plan-right now.
Check the FDA Drug Shortage Database First
The first thing you should do when you hear your medication is unavailable is check the FDA Drug Shortage Database. It’s free, updated daily, and lists every active shortage with official alternatives. For example, if Semglee (a biosimilar insulin) is out, the FDA confirms Lantus is a direct substitute-no new prescription needed. But if you’re looking for Tresiba or Toujeo, those require a new doctor’s note. The database doesn’t tell you which pharmacy has stock, but it tells you what’s medically safe to switch to. Don’t guess. Don’t rely on pharmacy staff alone. Verify with the FDA’s list before making any changes.Call Multiple Pharmacies-Including Mail-Order
One pharmacy being out doesn’t mean they’re all out. In March 2025, a Reddit user named DiabeticDad87 contacted seven different pharmacies over three days before finding Semglee. That’s not rare. Large chain pharmacies like CVS, Walgreens, and Rite Aid often have different inventory levels. Smaller independent pharmacies sometimes get shipments before chains. And mail-order pharmacies? They’re often your best bet. Many insurers cover them, and they receive bulk shipments that local stores don’t. Ask your pharmacist if they can order from a regional distributor. Some can get drugs within 48 hours that your local store can’t. Don’t give up after one or two calls. Keep a list of phone numbers handy.Ask Your Doctor About Therapeutic Alternatives
Not all substitutes are created equal. For antibiotics, if amoxicillin is gone, azithromycin might be offered-but it’s not the same. It works differently, has different side effects, and can worsen antibiotic resistance if used improperly. For insulin, switching from one long-acting type to another may require dose adjustments. Your doctor needs to know what’s available and what’s safe for you. A 2025 survey by the Sterling Institute found that 68% of patients who successfully switched medications did so only after talking to their provider. The other 32% stopped taking their meds entirely-and ended up in the ER. Don’t be one of them. Bring up alternatives early, even before you run out. Ask: “If this drug runs out again, what’s the next safest option for me?”
Understand Biosimilars and Formulary Rules
Biosimilars like Semglee are designed to be interchangeable with brand-name drugs like Lantus. That means pharmacists can swap them without a new prescription. But not all substitutes are like this. Some drugs require prior authorization from your insurance. In early 2025, Blue Cross NC removed prior auth for Lantus on some plans during the Semglee shortage-but only for specific formularies. If you’re on a “Net Results” or “Essential” plan, you might still be blocked. Call your insurer. Ask: “Is this alternative covered under my plan without extra steps?” If your insurer says no, ask your doctor to file a medical exception. Many are approved if you explain the shortage. Don’t assume you’re stuck-there’s often a path.Look Into State-Level Solutions
Some states are taking action. In Hawaii, Medicaid now allows foreign-approved versions of drugs during shortages-like insulin made in Canada or Europe that meet safety standards but aren’t FDA-approved for U.S. sale. New Jersey is considering letting pharmacists hand out emergency insulin without a prescription. New York is building a real-time database showing which pharmacies have what in stock. These aren’t nationwide yet, but they’re happening. Check your state’s board of pharmacy website. If you’re in California, Massachusetts, or Washington, you might be eligible for emergency stockpiles of certain drugs, like abortion medications or epinephrine auto-injectors. Even if your state hasn’t passed laws, your local health department might have resources or referral lists.Reach Out to the Manufacturer
Pharmaceutical companies know when their products are running low. Pfizer, Sanofi, and Eli Lilly all publish shortage updates on their websites. During the amoxicillin shortage, Pfizer posted estimated restock dates-helping patients plan ahead. If your drug is made by a major company, go to their patient support page. Many offer free samples, discount programs, or even direct shipping during shortages. Some have dedicated hotlines for patients in crisis. Don’t wait until you’re out. Call them now. Ask: “When will this drug be available again? Can you help me get a temporary supply?”