Background:Drug shortages have posed clinical and economic challenges to healthcare systems in countries globally.
Objectives:This study aimed to characterize and assess the present situation in Sichuan China, and analyze the main causes and explore possible mitigation or solution strategies.
Methods:We extracted data from the multi-source drug shortage reporting system of Sichuan in south-western China from1 January 2018 to 30 May 2021. We classified the drugs the WHO Anatomic-Therapeutic Chemical (ATC) classification system. We used descriptive statistics to analyze the distribution of characteristics.
Results: There were 2,221 reports of drug shortage, among which 2,193(98.74%) were valid. Shortages were mainly reported by the sentinel hospitals at different levels (1,273, 58.05%) and Members of the Sichuan Drug Shortage Consultation Linkage Mechanism (513, 23.39%) (table 1). There were 732 types of drugs in shortage, of which the average frequency of shortage was 2.99. Chemical drugs were the most reported drug type (84.91%), followed by traditional Chinese medicine (12.72%), biological product (1.82%), health care products (0.18%) and pharmaceutical excipients (0.36%). In terms of ATC classification, cardiovascular system drugs had the most frequency of shortage (338), and digestive tract and metabolic drugs had the largest number of drug types (89) (table 2). In terms of dosage forms, injections accounted for the most frequency of shortage (1,060), and oral agent had the largest total number of drug types (450). 55.36% of the drug in shortage information were essential drugs, and 87.37% of the drug in shortage information were medical insurance drugs (table 3). The main causes of drug shortage were insufficient production capacity caused by shortage of raw materials (36.06%), rising drug prices (15.84%), and small clinical usage volume (14.44%) (Figure 1).
Conclusions:There was a wide variety of drugs in shortage, covering a wide range of therapeutic areas in Sichuan province. Drug shortage existed in medical institutions at all levels. The cause of drug shortage existed in all the drug circulation, including production, delivery and use process, closer multi-departmental cooperation and multi-ways are needed to solve the drug shortage problem to ensure the adequate supply of clinical drugs.
Patient, public and/or healthcare consumer involvement:There is no involvement.

Table 1-3 and Figure 1.pdf