The Home Study: Drug Shortage Clinical Navigation as a Pharmacist Workflow

U.S. drug shortages reached an all-time record in 2024 and remain elevated, and the pharmacist is the clinician who encounters them first: at the counter, with the patient present, often before the prescriber is aware. Published guidance from ASHP establishes how health systems should manage shortages at the institutional level, but the community and outpatient pharmacist's real-time decision, substitute within scope, escalate to the prescriber, or conserve and counsel, is rarely taught as a structured workflow, and the practical mechanics around that decision (efficient prescriber communication, insurance navigation, patient trust) are taught even less. Pharmacy-education literature has separately identified drug-shortage management as inconsistently integrated into formal curricula. The result is ad hoc decision-making: dispensing delays, inconsistent substitution, under-escalation of narrow-therapeutic-index and other high-risk drug categories, unresolved insurance friction that falls back on the patient, and missed opportunities to preserve patient trust and conservation counseling. The purpose of this application-based activity is to equip pharmacists with a structured shortage-navigation workflow, and the communication and documentation skills around it, that turn the dispensing-moment decision into a repeatable clinical process.