High-fragility drugs
A descriptive 0–100 score estimating how likely a drug is to become hard to get, recomputed daily for every NADAC-priced product. Higher means more fragile. It is a screening signal built from public data — not a prediction, and not clinical or purchasing advice.
ⓘ How this was built
- FDA NDC Directory (labeler counts)
- FDA drug shortages (openFDA)
- openFDA drug enforcement (recalls)
- NADAC prices (data.medicaid.gov)
Additive points per factor (table at the bottom of this page), recomputed daily for every NADAC-priced NDC. Descriptive, not fitted: the weights are chosen for legibility, and every score lists its reasons.
Pipeline and calculations built by Claude (Fable 5) from the public datasets above. Educational only — verify against primary sources before acting.
Predicted 90-day shortage risk model v2
A statistical model estimating, for each drug market, the probability that a new FDA shortage posting appears within the next 90 days. Unlike the descriptive score above, this was trained on history and validated on a held-out period it never saw: on 2022–2026 data the model ranked markets with an AUC of 0.7083 (0.5 = coin flip, 1.0 = perfect).
ⓘ How this was built
- FDA drug shortages via openFDA + Internet Archive snapshots of FDA's shortage CSV (2019–present)
- FDA NDC Directory (labeler marketing windows)
- NADAC pharmacy acquisition prices (data.medicaid.gov)
- openFDA drug enforcement (recalls)
- FDA Data Dashboard inspection classifications
- DECRS + DailyMed SPL (drug-to-facility links)
Logistic regression over 120,331 market-month observations since Nov 2019. Features at each date use only data knowable then (labeler counts from FDA marketing dates, price change YoY, recalls, form, discontinuation filings, open shortages, facility inspections); the label is a new shortage posting within 90 days. Backtested with a temporal split at 2022-07-01: held-out AUC 0.7083 vs 0.7287 in training.
- n_labelers: -0.09
- sole_source: -0.38
- nadac_yoy: +0.19
- recalls_12mo: +0.06
- injectable: +0.26
- tbd_active: +0.21
- active_episodes: +0.13
- oai_24mo: +0.13
Pipeline and calculations built by Claude (Fable 5) from the public datasets above. Educational only — verify against primary sources before acting.
- 1.6%waterinjectableprice up 205% YoY · sterile injectable · OAI inspection at a producing facility (24 months)
- 1.5%sodium chlorideinjectablesterile injectable · 13 Class I/II recall(s) in 12 months · OAI inspection at a producing facility (24 months)
- 1.1%lorazepaminjectablesterile injectable · price up 94% YoY · OAI inspection at a producing facility (24 months)
- 0.9%bacteriostatic waterinjectablesterile injectable · price up 118% YoY · sole-source market
- 0.9%clemastine fumarateoral solidprice up 540% YoY · sole-source market
- 0.8%sodium chloride, sodium lactate, potassium chloride, calcium chlorideinjectablesterile injectable · price up 31% YoY · OAI inspection at a producing facility (24 months)
- 0.7%fentanyl citrateinjectablesterile injectable · price up 70% YoY · sole-source market
- 0.7%pantoprazole sodiuminjectablesterile injectable · price up 28% YoY · OAI inspection at a producing facility (24 months)
- 0.6%lidocaine hydrochlorideinjectablesterile injectable · 4 Class I/II recall(s) in 12 months · OAI inspection at a producing facility (24 months)
- 0.6%certolizumab pegolinjectablesterile injectable · OAI inspection at a producing facility (24 months) · sole-source market
- 0.6%ceftriaxone sodiuminjectablesterile injectable · OAI inspection at a producing facility (24 months) · price up 15% YoY
- 0.6%fondaparinux sodiuminjectablesterile injectable · OAI inspection at a producing facility (24 months) · sole-source market
- 0.6%desmopressin acetateinjectablesterile injectable · OAI inspection at a producing facility (24 months) · price up 13% YoY
- 0.6%furosemideinjectablesterile injectable · OAI inspection at a producing facility (24 months) · price up 19% YoY
- 0.6%hydrocortisone sodium succinateinjectablesterile injectable · OAI inspection at a producing facility (24 months) · sole-source market
Probabilities are small because new shortage postings are rare right now (~a few per month across all drugs) — what matters is the ranking. Not clinical or purchasing advice.
Fragility Score — filter or click a column to sort
| 65High | Hydroxocobalamin HYDROXOCOBALAMIN ACETATE 1000 ug/mL · Injection, Solution | Actavis Pharma, Inc. | 1 active manufacturer +30in shortage now +25sterile injectable +10 |
| 65High | Methotrexate METHOTREXATE 25 mg/mL · Injection | Accord Healthcare, Inc. | 1 active manufacturer +30in shortage now +25sterile injectable +10 |
| 65High | Methotrexate METHOTREXATE SODIUM 25 mg/mL · Injection, Solution | Fresenius Kabi USA, LLC | 1 active manufacturer +30in shortage now +25sterile injectable +10 |
| 65High | Sodium Bicarbonate SODIUM BICARBONATE 84 mg/mL · Solution | Long Grove Pharmaceuticals, LLC | 1 active manufacturer +30in shortage now +25sterile injectable +10 |
| 63High | Dextroamphetamine Saccharate and Amphetamine Aspartate and Dextroamphetamine Sulfate and Amphetamine Sulfate DEXTROAMPHETAMINE SACCHARATE 1.875 mg/1; AMPHETAMINE ASPARTATE MONOHYDRATE 1.875 mg/1; DEXTROAMPHETAMINE SULFATE 1.875 mg/1; AMPHETAMINE SULFATE 1.875 mg/1 · Tablet | SpecGx LLC | 1 active manufacturer +30in shortage now +25price down 20% year over year +8 |
| 63High | Lisdexamfetamine dimesylate LISDEXAMFETAMINE DIMESYLATE 20 mg/1 · Capsule | Solco Healthcare US,LLC | 1 active manufacturer +30in shortage now +25price down 30% year over year +8 |
| 63High | Lisdexamfetamine dimesylate LISDEXAMFETAMINE DIMESYLATE 30 mg/1 · Capsule | Solco Healthcare US,LLC | 1 active manufacturer +30in shortage now +25price down 26% year over year +8 |
| 63High | Lisdexamfetamine dimesylate LISDEXAMFETAMINE DIMESYLATE 50 mg/1 · Capsule | Solco Healthcare US,LLC | 1 active manufacturer +30in shortage now +25price down 28% year over year +8 |
| 63High | Lisdexamfetamine dimesylate LISDEXAMFETAMINE DIMESYLATE 60 mg/1 · Capsule | Solco Healthcare US,LLC | 1 active manufacturer +30in shortage now +25price down 23% year over year +8 |
| 63High | Lisdexamfetamine dimesylate LISDEXAMFETAMINE DIMESYLATE 70 mg/1 · Capsule | Solco Healthcare US,LLC | 1 active manufacturer +30in shortage now +25price down 25% year over year +8 |
| 63High | Lisdexamfetamine dimesylate LISDEXAMFETAMINE DIMESYLATE 40 mg/1 · Capsule | Solco Healthcare US,LLC | 1 active manufacturer +30in shortage now +25price down 29% year over year +8 |
| 63High | Lisdexamfetamine dimesylate LISDEXAMFETAMINE DIMESYLATE 10 mg/1 · Capsule | Solco Healthcare US,LLC | 1 active manufacturer +30in shortage now +25price down 23% year over year +8 |
| 63High | rocuronium bromide ROCURONIUM BROMIDE 10 mg/mL · Solution | XGen Pharmaceuticals DJB, Inc. | 2 active manufacturers +20in shortage now +25price down 25% year over year +8sterile injectable +10 |
| 60High | Desmopressin Acetate DESMOPRESSIN ACETATE 10 ug/1 · Spray | Apotex Corp. | 2 active manufacturers +20in shortage now +25Class I/II recall in past 12 months +15 |
| 58High | Dexamethasone Sodium Phosphate DEXAMETHASONE SODIUM PHOSPHATE 10 mg/mL · Injection, Solution | Fresenius Kabi USA, LLC | in shortage now +25Class I/II recall on same molecule/form in past 12 months +8price down 66% year over year +15sterile injectable +10 |
| 58High | Dexamethasone Sodium Phosphate DEXAMETHASONE SODIUM PHOSPHATE 10 mg/mL · Injection, Solution | Somerset Therapeutics, LLC | in shortage now +25Class I/II recall in past 12 months +15price down 34% year over year +8sterile injectable +10 |
| 58High | Liraglutide LIRAGLUTIDE 6 mg/mL · Injection | Hikma Pharmaceuticals USA Inc. | in shortage now +25Class I/II recall on same molecule/form in past 12 months +8price down 42% year over year +15sterile injectable +10 |
| 58High | Liraglutide LIRAGLUTIDE 6 mg/mL · Injection | Teva Pharmaceuticals USA, Inc. | in shortage now +25Class I/II recall on same molecule/form in past 12 months +8price down 42% year over year +15sterile injectable +10 |
| 58High | Liraglutide LIRAGLUTIDE 6 mg/mL · Injection | Teva Pharmaceuticals USA, Inc. | in shortage now +25Class I/II recall on same molecule/form in past 12 months +8price down 48% year over year +15sterile injectable +10 |
| 58High | Liraglutide LIRAGLUTIDE 6 mg/mL · Injection | Meitheal Pharmaceuticals Inc. | in shortage now +25Class I/II recall on same molecule/form in past 12 months +8price down 48% year over year +15sterile injectable +10 |
Showing 20 of 200 scored drugs (score 25+)
Where the fragile drugs are made
A fragile drug made in only one country has a single point of failure. Of the 1,307 elevated/high-fragility drugs we can trace to a manufacturing country, 1,177 (90%) are made in a single country — and 689 of those are made entirely outside the US. How we know where drugs are made →
Single-country fragile drugs by country · amber = made only outside the US. Traceable for 1,307 of 2,645 elevated/high-fragility drugs; the rest carry no manufacturing country in their FDA label.
| 65 | Methotrexate METHOTREXATE 25 mg/mL · Injection | India | Accord Healthcare, Inc. |
| 58 | Dexamethasone Sodium Phosphate DEXAMETHASONE SODIUM PHOSPHATE 10 mg/mL · Injection, Solution | India | Somerset Therapeutics, LLC |
| 55 | Lamotrigine Extended Release LAMOTRIGINE 25 mg/1 · Tablet | China | Par Health USA, LLC |
| 55 | Methotrexate METHOTREXATE 25 mg/mL · Injection | India | Accord Healthcare, Inc. |
| 51 | Lidocaine Hydrochloride LIDOCAINE HYDROCHLORIDE 10 mg/mL · Injection, Solution | India | Eugia US LLC |
| 50 | Dexamethasone Sodium Phosphate DEXAMETHASONE SODIUM PHOSPHATE 10 mg/mL · Injection | India | Eugia US LLC |
| 50 | Dexamethasone Sodium Phosphate DEXAMETHASONE SODIUM PHOSPHATE 10 mg/mL · Injection | India | Somerset Therapeutics, LLC |
| 45 | amlodipine,valsartan and hydrochlorothiazide AMLODIPINE BESYLATE 10 mg/1; VALSARTAN 160 mg/1; HYDROCHLOROTHIAZIDE 12.5 mg/1 · Tablet, Film Coated | India | Macleods Pharmaceuticals Limited |
| 45 | Bepotastine Besilate BEPOTASTINE BESILATE 15 mg/mL · Solution | India | Somerset Therapeutics, LLC |
| 45 | Clindamycin Phosphate and Tretinoin Gel 1.2%/0.025% CLINDAMYCIN PHOSPHATE 10 mg/g; TRETINOIN .25 mg/g · Gel | India | Encube Ethicals, Inc. |
| 45 | Dipyridamole DIPYRIDAMOLE 75 mg/1 · Tablet | India | Amneal Pharmaceuticals of New York LLC |
| 45 | Glyxambi EMPAGLIFLOZIN 25 mg/1; LINAGLIPTIN 5 mg/1 · Tablet, Film Coated | Germany | Boehringer Ingelheim Pharmaceuticals, Inc. |
Showing 12 of 250 single-country fragile drugs.
How the score is calculated
Points from each factor below are added and capped at 100. Every score on this site lists exactly which factors fired and how many points each contributed — nothing is hidden in a black box.
| Factor | Max points | How it's measured |
|---|---|---|
| Few active manufacturers | up to +30 | Counted per molecule + dosage form, from labelers seen in the FDA NDC Directory in the last 30 days. Sole-source (1 maker) +30, 2 makers +20, 3 makers +10, 4–5 makers +5. A thin supplier base is the single biggest driver — one plant problem can empty the market. |
| Shortage status | up to +25 | This exact product currently in FDA shortage +25; a related presentation of the same molecule/form in shortage +15; a shortage of this product resolved within the last 12 months +8. |
| Recent serious recall | up to +15 | A Class I or II FDA recall touching this NDC in the last 12 months +15; a Class I/II recall on the same molecule/form (different NDC) +8. |
| Sustained price deflation | up to +15 | NADAC unit price down 40%+ year-over-year +15, or down 20%+ +8. Generics driven too cheap are the ones manufacturers abandon — falling price is a leading indicator of exit. |
| Sterile injectable form | +10 | Injectable / intravenous dosage forms are structurally fragile — complex sterile manufacturing, few lines, long recovery from any disruption. |
| Planned discontinuation | +10 | A manufacturer has filed a “to be discontinued” notice with FDA for this product — capacity leaving the market. |
Bands:50–100 High · 25–49 Elevated · 0–24 Low. Only drugs with a NADAC price are scored, so hospital-only and unpriced products aren't rated.
Sources: FDA NDC Directory (manufacturer counts), FDA drug shortages and enforcement/recall reports, and CMS NADAC pricing. Recomputed daily; data as of Sep 2, 2026.
Known limits: manufacturer counts include repackagers, so a market can look less concentrated than it is; the score describes current conditions and does not forecast; and it can't see upstream API sourcing or private contract terms.