2026 Eastern States Conference

Title: Operational and financial impacts of backorders and shortages at Geisinger
Authors: Maxwell McGuire, PharmD; Bradley Dudeck, PharmD, BCPS; Sarah Siemion, PharmD, BCPS; Kristen Franklin, PharmD, BCCCP; Vanessa Markle, PharmD, BCPS
Objective: At the conclusion of the presentation, the participant will be able to describe a mixed-methods approach to evaluating the financial and operational impact of inpatient drug shortages and backorders within a health system.
Self-Assessment Question: Which metric best reflects the indirect operational burden of a medication shortage?
A) Staff hours spent managing shortage-related tasks
B) Contract purchase price
C) Annual drug spend alone
D) Inventory par level
Background: Drug shortages and backorders disrupt hospital operations, yet system-level data on financial and operational impact remain limited. Rural health systems face added risk from supply constraints. This study aims to quantify costs and labor burden.
Methods: A mixed-methods evaluation will be conducted. The financial analysis will review purchasing and inventory data from Aug 1, 2023, to Sep 1, 2025, to identify fulfillment delays, cost increases, alternative sourcing patterns, and the frequency and duration of backorders for high-impact inpatient medications. Descriptive and comparative analyses will estimate excess cost attributable to shortage periods. The operational analysis will use an anonymous survey distributed to pharmacy, nursing, providers, and operational leaders to assess time spent on shortage tasks, workflow disruptions, perceived burden, communication challenges, and role-specific impact. Reported labor time will be converted into personnel cost to quantify indirect workload. Findings will be compared across floors and departments to evaluate variation in operational burden.
Results: Over the 25-month study period, $7.7M was spent on shortage-affected inpatient medications; $0.7M (9%) represented incremental cost directly attributable to backorders, annualizing to $321,323.11 in direct spend. Leading incremental cost drivers were iron sucrose, liposomal amphotericin B, glucagon, insulin, and labetalol. Survey respondents (19/44) reported 5,326 labor hours per year managing shortages—led by pharmacy procurement (1,528 hrs) and providers (718 hrs)—annualizing to $448,970.30 in operational cost. 71% of respondents reported severe workflow impact, supporting the hypothesis that indirect operational burden substantially exceeds direct financial cost.
Conclusion: Drug shortages impose a substantial operational burden on health systems that far outweighs their direct financial footprint. These findings highlight the need to invest in proactive shortage-management infrastructure, standardized communication, dedicated procurement, and cross-disciplinary coordination, rather than focusing on drug acquisition cost alone. Hospital leaders can use this framework to justify staffing, prioritize mitigation strategies, and protect continuity of patient care.
  

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