Strategic Spend: Supply shortages keep climbing — but assurance pushes forward

Picture yourself on a mountain trail—the fresh air and the steady crunch of gravel under your boots. You’ve been climbing for miles, one step at a time, breath heavy, heart pounding. But the peak is in sight, and you push through the last stretch, legs burning. You’re almost there. Until finally, finally—

You reach the top. Ecstatic. Euphoric. Certain you’ve conquered the hardest part.

But then you turn around and find another, higher peak.

What you thought was the finish line was only a false summit. The trail isn’t over.

There’s more ahead than you realized.

It’s a humbling experience—to have gone so far—and then learned there is still so much more to go.

It’s the same with our multiyear efforts to address and prevent supply shortages. Every time we feel like we’ve reached a new level of resiliency for essential medications and products, we’re met with another challenge—another switchback, another climb. That’s the reality of this work. It takes endurance, adaptability, and a willingness to keep going, even when the path changes.

Drug shortages are not a new challenge. For the last two decades, disruptions across pharmaceutical supply chains have been a routine occurrence for healthcare providers. But for many, the issue came into sharper focus in 2017, when Hurricane Maria hit Puerto Rico and impacted 54 drug manufacturing facilities.

Through Novaplus—our private label program offering a broad portfolio of essential medications and medical-surgical products—Vizient has encouraged suppliers to prioritize domestic production and sourcing. While Puerto Rico is part of the U.S., this moment revealed something different: the risk of having too much manufacturing concentrated in one place. It pushed us to look more closely at where and how products are made, and to strengthen how we approach sourcing within the Novaplus program.

This realization also made it clear that we needed to better understand what shortages were really costing healthcare teams. Pharmacists and pharmacy technicians have largely shielded patients from the impact, but the scale of that effort hadn’t been fully measured.

In 2019, we launched a drug shortages survey that showed managing shortages costs the healthcare industry nearly $360 million annually in labor. When we repeated the survey with 2023 data, that number had grown to more than $900 million. It also reinforced something we were seeing in the field—the need to focus on essential medications, like propofol, that health systems simply cannot function without.

In January 2020, alongside the distribution of the first Essential Medications List, we launched Novaplus Enhanced Supply (NES), which built upon Novaplus by adding assurance features that require participating suppliers to maintain increased inventory levels and provide enhanced transparency, helping protect clients against supply disruptions. The goal was to enhance access for 90 critical, lifesaving drugs. We started with propofol.

And coincidentally—and unknowingly—propofol became the most in-demand drug two months later when COVID-19 hit the United States.

From February to April, there was a 280% average increase in demand for 50ml and 100ml vials of propofol—a drug needed to care for patients on ventilators. Fortunately, NES enabled access to 676,000 additional units of propofol—but 676,000 vials wasn’t good enough. Not to me, and not to Vizient.

I felt humbled by that mountain again.

But the great thing about these challenges—about these false summits—is that they force you to do something different. To try something new.

And that’s what we did here at Vizient—what we keep doing here at Vizient.

The pandemic brought increased attention to drug shortages from government agencies like the U.S. Food and Drug Administration and Department of Health and Human Services—opening the door for more collaboration across the healthcare industry.

In 2021, we established the End Drug Shortages Alliance (EDSA), a coalition of healthcare organizations with a single goal: to combat drug shortages through increased transparency and resourcefulness. Since then, EDSA has grown into a nonprofit with more than 80 member organizations including healthcare providers, pharmaceutical manufacturers, suppliers, distributors, and group purchasing organizations.

Another mountain climbed.

And in 2022, another COVID-19 outbreak in China effectively shut down GE’s Shanghai plant. It led to a shortage of contrast media, a product used in x-rays, CT scans, fluoroscopy, and cath lab, and interventional procedures. By this point, we’d already launched Vizient Reserve—a program that further extends NES by acting as a safety net during severe shortages or emergencies. We had over 270 products on contract, but we couldn’t have predicted COVID would hit again—and we certainly couldn’t have anticipated that a shortage in contrast media would be the next challenge health systems faced.

So, we evolved our response strategy again—strengthening our communications by offering disruption briefs and FAQs. We also launched dedicated command centers for this and each future disaster and added contrast media to our Vizient Reserve portfolio.

As with each time an unexpected event occurred, we got better.

When a tornado hit the Pfizer Rocky Mount plant in July 2023—causing damage to their warehouse and manufacturing facility—and Hurricane Helene devastated the Baxter North Cove facility in October 2024, we got to work and did what we do best: created mitigation strategies, a supply assurance market brief, and FAQs. We sent regular updates through our Pharmacy Hot Info newsletter and—for the first time—combined Vizient pharmacy and supply assurance teams’ expertise to orchestrate a cross-functional webinar that brought together providers and suppliers.

Pfizer was up and running again soon after the tornado, but the devastation to Baxter’s facility halted production of nearly 60% of the country’s IV fluids and in July 2025—just nine months later—we expanded Vizient Reserve to include IV fluids through a collaboration with Baxter, ensuring reliable access to these critical products. (Since its launch, Vizient Reserve has enrolled 300 health systems and fielded more than 38,000 requests for critical, life-saving products—making it the fastest-growing program in Vizient’s history.)

Unexpected events will happen—a global pandemic, a tornado that takes out the plant supplying 60% of a critical product, or a hurricane that impacts 54 drug manufacturers at once. And we’re seeing that play out again in real time. Most recently, as suppliers like Stryker navigate cybersecurity disruptions, we’re working alongside them and providers across the country, leveraging the same playbook we’ve built through each of these challenges. From real-time communication to coordinated mitigation strategies, our focus remains the same: ensuring continuity of care, even when the disruption looks different than anything we’ve faced before.

You can’t predict every disruption, but you can learn from each one and build stronger because of it.

This ongoing journey has been long, marked by obstacles and more than a few false summits. Yet, every day, I’m reminded that the progress we’ve made is remarkable. Since we first laced up our hiking boots and set out on this trail, we’ve helped more than 5.5 million patients receive the life-saving drugs they need across more than 9,000 Vizient and non-Vizient sites—and that impact has made every step worth the climb.