Drug supply chain disruptions and outpatient medication shortages in the Veterans Health Administration, 2017-2020.

Purpose: We sought to describe how often and circumstances in which supply chain disruptions were associated with outpatient drug shortages within the Veterans Health Administration (VHA). Methods: We conducted a descriptive analysis of VHA purchasing data for drugs used to treat chronic conditions for outpatients with a supply chain report from 2017 to 2020. In primary analyses, a VHA drug shortage was defined as a ≥ 10% absolute decrease in percentage of doses ordered that were filled by the wholesaler and/or a ≥ 10% relative decrease in total number of doses filled, comparing the 3 months after the reporting date with the 6 months before. We also examined longitudinal ordering and filling data over 12 months before and after the reporting date by whether the medication resulted in a shortage to VHA. Results: Of 64 medications with supply chain disruptions, 67% ( Conclusions: Among ambulatory-focused medications for chronic conditions, a high proportion of those with supply chain disruptions were associated with shortages to VHA. Sharp increases in medication ordering may serve as an early signal of shortages.