The Drug Shortage Era: A Scoping Review of the Literature 2001-2019.

Drug shortages continue at crisis levels in the United States, with no end in sight. Extensive research in disparate areas has been conducted to explore the impact that shortages have on patients and the healthcare system. We conducted a scoping review to categorize existing work in order to identify opportunities for further research. We considered peer-reviewed and non-peer-reviewed articles involving non-vaccine, human drug shortages in the United States published in English between January 2001 and May 2019. In total, 430 papers were charted according to the following categories: causes, impacts on care, health outcomes, costs, management, prevention, and federal government response. Of these, 112 papers considered causes; 199 discussed effects, 158 considered management strategies, and 140 discussed prevention. We provide a resource to navigate the vast literature on drug shortages in the United States, identifying areas in need of further research. This review highlights the widespread negative effects that drug shortages have on patients, providers, and health system costs in the United States. Evidence of their ramifications should be sufficient to justify policy change. Future work should move from characterizing the problem to working toward solutions to reduce the impact, occurrence, and effects of shortages.