U.S. shortages dropped 23% in 2025, but the average shortage now lasts 5.3 years. As that gap widens, Washington is winning a court test on hospital prices at home while pressuring Europe to raise them abroad.
U.S. prescription drug shortages fell 23% in 2025, the second straight annual drop and the lowest count since 2017, according to an analysis by U.S. Pharmacopeia cited by STAT. On paper, the supply crisis is easing. In practice, it is hardening into something different and arguably worse: a chronic shortage tail that lasts years, not months.
The average drug shortage now stretches 5.3 years, up from 4.3 years in 2024 and roughly 2 years in 2019, per the same USP analysis. Nearly two-thirds of medicines currently out of stock have been unavailable for more than three years. About 39% have been gone for more than five years. The 75 drugs in short supply last year spanned 130 therapeutic categories, a breadth that signals systemic, not narrow, fragility. Patients are facing shorter lines at the front of the pharmacy counter and a longer, slower emergency room at the back.
That paradox is now the backdrop for three simultaneous policy tests playing out on different continents, none of them a clean win. A federal judge denied a pharmaceutical industry challenge to a Washington state law designed to reduce hospital drug prices, according to STAT's Pharmalittle newsletter. The case was a test of whether states can use procurement-side pressure to push back on hospital markups, a much smaller lever than federal negotiation but one that has survived industry pushback so far. The ruling does not end the fight. It keeps the law on the books while litigation continues, and it gives other states a live template to copy or contest.
The picture abroad is messier than the wire's clean narrative. The U.K., after a campaign by drugmakers and the Trump administration, has shifted toward more industry-friendly pricing policies and pledged higher medicine spending, STAT reported in December 2025. Germany is moving the other way. Facing a strained health budget, the German government has proposed cutting drug spending and raising industry-paid fees, according to STAT's European bureau. The two biggest European economies are now running drug-pricing experiments in opposite directions under the same macro pressure from Washington and the same industry lobbying push. London capitulated. Berlin has not.
That divergence makes any "Europe is caving to U.S. pressure" story too simple. It also clarifies what the U.S. campaign is actually doing. Washington is pushing hospital prices down at home through state law and judicial wins. It is pushing European prices up through diplomatic pressure that has, at least in the U.K., produced industry-friendly concessions. Both directions serve the same long-running political goal: making drug prices look more favorable to U.S. consumers and investors by relocating the cost to European taxpayers or to U.S. state budgets.
The shortage data complicates that picture. If supply is structurally tight and getting tighter on duration, then squeezing any single point in the pricing chain just moves the squeeze somewhere else. The patients who depend on the 75 chronically short drugs are the ones absorbing the delay. A 5.3-year average duration is not a supply chain glitch. It is a market signal that something has gone wrong in the pricing-and-production system, and that signal is getting louder even as the headline count falls.
What to watch next: whether the Washington state hospital pricing law survives appeal and whether other states follow; whether Germany holds its line on industry fees, or whether Berlin collapses under pressure the way London did; and whether USP's count-versus-duration gap continues to widen, and whether Congress or FDA starts treating duration, not count, as the metric that matters.
The headline number says drug shortages are getting better. The tail says they are getting worse. Both can be true. The policy fights now playing out in courtrooms, in London, and in Berlin will determine which one ends up mattering more.