Vulnerable medicine list to aid US medicine supply resilience

The US Pharmacopeia (USP) has published its 2024-2025 Vulnerable Medicines List for the US, cataloguing “a data-based approach to identify risks and enable interventions to increase reliability of supply’.

The organisation identified 100 vulnerable medicines, with the aim to foster discussion and action to boost resilience of the medicine supply chain.

“A data-driven, vulnerability-informed approach can help inform stakeholder actions – including drug makers, purchasing entities such as hospitals and GPOs, and policymakers to effectively build a more resilient medicines supply chain,” explained Anthony Lakavage, Senior Vice President for Global External Affairs at USP.

To collate the report, the vulnerability of medicines to supply chain disruptions was measured using predicted shortage risk scores from the USP Medicine Supply Map, Vulnerability factors that were considered included manufacturing complexity, geographic concentration of production and drug shortage history, USP noted.

A summary of this analysis were as follows:

• Of the vulnerable drugs listed, the most prevalent therapeutic classes included pain management, oncology, hospital solutions, and antibacterial medications. Of the total eleven oncology drugs on the list, one medicine for chronic condition management medicine (methotrexate injection) was identified and 10 medicines were acute care medicines.
• Sixty one percent of the drugs on the list were not in shortage, as of January 2025
• Injectable drugs constituted the majority of medicines highlighted in USP’s report, accounting for 71 percent of all medications. The drugs identified as most vulnerable were all injectables – sodium chloride injection, dextrose injection, heparin sodium injection, propofol injectable emulsion, and lidocaine hydrochloride injection.
• On the other hand, oral solid drugs represented the second-largest group (15 percent) of the total vulnerable drugs.

USP concluded in its report that the Vulnerable Medicines List “is intended to complement other resources to identify potential drugs at risk of shortage in the US”, and that further research and analysis can improve measurement of medicine supply vulnerability.