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Mayo Clinic

Pharmacy operations · Case study

Mayo Clinic: keep drugs in shortage covered

Carry each shortage-affected drug from first listing through substitutes, supply, site allocation and the committee’s recorded decisions.

By OneShot · Updated

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What the workflow produces

Drug shortage record
Shortage
Listing, affected products, days of supply by site and estimated resolution range.
Substitutes
Adverse-event, cost, recall and device-clearance findings for each alternative.
Supply and allocation
Supplier answers with dates and the approved quantities for each site.
Committee decision
Approved substitutes, restrictions, conservation measures and review date.

The documented problem

In July 2022, Mayo Clinic’s News Network reported more than 200 ongoing and active drug shortages per year in the U.S. since 2018. Mayo’s director of pharmaceutical supply and procurement for its Midwest locations described escalating when an order arrives short of what patients need, then engaging front-line staff, changing the electronic health record where needed and asking formulary colleagues which alternatives or substitutes can be used.

Mayo says its Pharmacy and Therapeutics Committee has an organized approach to managing each shortage, and that Mayo joined an industry alliance on shortages and was a founding member of a nonprofit generic drug maker. HHS’s January 2025 analysis adds that injectable shortages from 2018 through 2023 lasted a median of 4.6 years, roughly twice as long as oral products. The OneShot workflow below keeps each affected drug covered across a health system’s sites until the shortage resolves.

The OneShot solution

Hospital drug shortage response across sites

Keep every shortage-affected drug on the formulary covered at every site, with an approved substitute, a supply plan and a recorded committee decision until the shortage resolves.

Work enters the queue
A new or changed shortage listing, an order that arrives short, a site falling below its days-of-supply threshold, a supplier answer or a new safety signal for an approved substitute.
Decision owner
Director of pharmacy supply, with the pharmacy and therapeutics committee
  1. 01

    Catch the listing

    The OneShot agent checks its drug-shortage lookup every day against the system’s formulary and matches each new or changed listing, and each order that arrives short, to the products each site stocks. Read on-hand stock and usage by site to work out days of supply, and open one record per affected drug.

  2. 02

    Estimate how long it lasts

    Use its prediction tool on the listing’s history, stated reason and number of suppliers to estimate a resolution date with a range, and research the manufacturers’ public statements. Revisit the estimate whenever the listing changes; it sets how far ahead substitution and allocation must plan and is never presented as a supply commitment.

  3. 03

    Assess the substitutes

    For each therapeutic alternative the formulary pharmacist names, check adverse-event reports with its drug-safety lookup, acquisition cost with its drug-pricing lookup and open recalls. Where the substitute changes the delivery device, such as a prefilled syringe or an infusion set, check its device clearance. Link every finding to its record; the clinical judgment stays with the pharmacist.

  4. 04

    Source the supply

    Find alternative manufacturers and wholesalers for the drug and its approved substitutes, then ask each allocation contact by email for available quantity, allocation terms and expected release dates. Call when a written answer stalls before a site reaches its threshold. Record each answer with its date; a promised release is not stock received.

  5. 05

    Allocate across sites

    Use its optimization tool to split on-hand and incoming stock across sites against expected use, the committee’s clinical priorities and transfer limits. Present the proposed allocation to the director of pharmacy supply; once approved, text each site’s pharmacy lead the quantities to send or receive.

  6. 06

    Keep the committee’s decisions on record

    Send the pharmacy and therapeutics committee the substitute evidence, supplier answers and duration estimate. Record each decision: approved substitutes, restrictions, conservation measures and the next review date. Reopen the record when the listing, a supplier answer or a safety signal changes; close it only when the drug is off the shortage list and every site is back at par.

What counts as complete

The drug is no longer listed in shortage, every site is back at par and the committee has recorded the end of any substitution or restriction.

Decisions and exceptions

  • A substitute with a new safety signal goes back to the committee before further use.
  • Supplier promises without a confirmed shipment do not count toward coverage.
  • Stock transfers and purchases move only on the director of pharmacy supply’s approval.
  • Clinical substitution decisions and health record changes stay with the committee, prescribers and the system’s own clinical teams.

What to measure

  • Affected drugs with an approved plan
  • Days of supply by site
  • Supplier answers outstanding
  • Time from listing to committee decision

Establish the baseline and review period before launch. Compare completed cases, unresolved work and reviewer corrections against the same scope.

The agent’s tool basket

OneShot gives its agents the tools to analyze records, communicate, research and act on authorized business data. The platform carries the workflow from the first action through to the recorded result.

  • Pharmacy inventory and formulary records

    Read on-hand stock, usage and par levels by site with the formulary; record committee decisions, approved substitutions and stock transfers.

Workflow pricing

Scope the full workflow around your volume, business systems and required outcome.

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