Put AI to Work

1. Dacarbazine Injection

Shortage Status & Sources

Source (Posted): Quva Brightstream (05/08/2026) and ASHP (09/15/2026)

Supply Performance

• Organizational 2-week fill rate: 10%
• Market 2-week fill rate: 49%
• Assessment: Your organization is experiencing substantially lower product availability than the broader market. This may indicate organization- or region-specific supply constraints, purchasing limitations, or wholesaler availability in addition to the broader shortage.

Utilization

• Overall utilization has remained consistent. 55 administrations over the last 7 days
• 2 departments administered dacarbazine within the past 7 days.
• 1 department demonstrated disproportionately high utilization compared with other departments.
• Assessment: Utilization is concentrated within a limited number of departments, providing an opportunity to focus mitigation efforts on the areas driving the greatest demand.

Potential Clinical Impact

• Days on hand: 8 days
• Current inventory, utilization, and a 10% organizational fill rate indicate a risk of supply depletion if availability does not improve.
• Recommended action: Prioritize dacarbazine for active shortage management. Review available inventory, expected replenishment, utilization by department, and clinically appropriate mitigation strategies to preserve supply and minimize potential disruption to patient care.

2. Mesalamine Extended-Release

Shortage Status & Sources

Source (Posted): ASHP (8/20/2026)

Supply Performance

• Organizational 2-week fill rate: 0%
• Market 2-week fill rate: 0%
• Assessment: The product has been discontinued, with no product fulfillment observed across either the organization or broader market. Continued reliance on this product is unlikely to be sustainable and warrants transition to an available alternative.

Utilization

• Overall utilization has remained consistent, with 87 administrations over the last 7 days.
• 6 departments administered mesalamine extended-release within the past 7 days.
• 2 departments demonstrated disproportionately high utilization compared with other departments.
• Assessment: Ongoing utilization despite product discontinuation creates a need to proactively transition impacted departments and patients to clinically appropriate alternatives before existing inventory is depleted.

Potential Clinical Impact

• Days on hand: 12 days
• Current inventory and utilization, combined with a 0% organizational and market fill rate, indicate existing supply will continue to decline without replenishment.
• Recommended action: Prioritize mesalamine extended-release for active mitigation. Identify remaining inventory and impacted departments, evaluate clinically appropriate formulary alternatives, and establish a transition plan to minimize disruption to therapy as existing inventory is depleted.

3. LORazepam Injection

Shortage Status & Sources

Source (Posted): ASHP (06/23/2015), FDA (05/03/2018), and Quva BrightStream (05/11/2026)

Supply Performance

• Organizational 2-week fill rate: 15%
• Market 2-week fill rate: 40%
• Assessment: Your region is performing well below the market, suggesting potential local purchasing, allocation, or sourcing constraints in addition to the broader shortage.

Utilization

• Overall utilization has increased significantly, with 196 administrations over the last 7 days, compared with 112 administrations during the prior 7-day period.
• 9 departments administered LORazepam injection within the past 7 days.
• 3 departments demonstrated disproportionately high utilization compared with other departments.
• Assessment: The recent 75% increase in utilization represents a meaningful change in demand. If elevated utilization continues, available inventory may decline more rapidly even if current fill rates remain stable.

Potential Clinical Impact

• Days on hand: 14 days
• Although current days on hand are 14 days, the recent utilization spike may accelerate inventory consumption and reduce future days on hand if increased demand persists.
• Recommended action: Monitor LORazepam injection utilization closely and investigate the departments contributing to the recent increase. Confirm whether the spike represents a temporary event or sustained change in demand, and evaluate inventory and expected replenishment to determine whether proactive mitigation is warranted.

Follow-up prompts

Surface the next decision and launch the appropriate workflow as conditions change:

• Dacarbazine: days on hand declines or the 10% fill rate persists. Launch an inventory review, identify available transfers, investigate purchasing and allocation constraints, and prepare a conservation recommendation.
• Action: Start dacarbazine inventory and sourcing review
• Mesalamine extended-release: inventory approaches depletion with no replenishment. Launch an alternative-therapy workflow to identify impacted departments and patients, assess formulary options, and draft a transition plan.
• Action: Start mesalamine alternative-therapy transition planning
• LORazepam: utilization remains elevated or the 15% organizational fill rate remains below the 40% market rate. Analyze demand by department, provider, order set, and preference set; investigate supplier availability, allocation, contracts, and alternative sourcing; then summarize the likely causes and recommend targeted conservation, workflow, and sourcing actions.
• Action: Start LORazepam demand, workflow, and sourcing analysis

Shortage status

• Unmanaged | High Priority | Essential Medication
• Tag: MEETING
• Affected: LORazepam 2 mg/mL injection vials/cartridges

Supply risk

• Organizational fill rate: 15%
• Market fill rate: 40%
• Your region is performing well below the market, suggesting potential local purchasing, allocation, or sourcing constraints in addition to the broader shortage.
• Reported drivers include increased demand, manufacturing delays, and regulatory delays.

Utilization & workflow insights

• 9 departments used injectable LORazepam within the past 7 days; highest-impact areas include MHC ICU N and MHC Emergency Department.
• 207 providers ordered it; high-ordering providers include TREND, EDUARDO; DELAET, NANA; STRAW, ANNETTE; and LANGWORTHY, CHRISTENA.
• 7 order sets drive 11.8% of orders; Alcohol Withdrawal Treatment (HCCH IP) alone drives 8.3%.
• 46 preference sets drive 85.7% of orders; ED RX Medications and Eduardo, Trent (56842) Medications Preference account for 22.4%.

Recommended actions

1. Protect critical inventory | Proceed

• Redistribute supply from MHC 5 Tower → MHC ICU N.
• Complete the 200-vial transfer from Blountstown Medical Center → Popular Bluff Healthcare.
• Monitor Days on Hand after redistribution.

Action: Review recommended inventory transfers

2. Reduce injectable utilization | Proceed

• Prioritize injectable LORazepam when oral therapy or appropriate alternatives are unsuitable.
• Focus conservation on MHC ICU N, the Emergency Department, and high-ordering providers.
• Reinforce oral LORazepam or midazolam when clinically appropriate.

Action: Review conservation plan

3. Optimize ordering workflows | Review

• Review the Alcohol Withdrawal Treatment (HCCH IP) order set.
• Review ED RX Medications and Eduardo, Trent (56842) Medications Preference.
• Reduce unnecessary injectable selection while preserving appropriate access.

Action: Review workflow changes

4. Target provider communication | Proceed

• Notify targeted providers of the shortage, conservation strategy, and appropriate alternatives.

Action: Draft provider alert

5. Investigate fill-rate gap | Investigate

• Review purchasing, allocation, supplier availability, contracts, and alternative sourcing to understand the 15% vs. 40% fill-rate gap.

Action: Investigate sourcing constraints

Decision

I've identified five actions to reduce shortage risk based on current supply, utilization, and ordering patterns.

Approve plan | Review actions | Modify plan

Monitor

Track:

• Days on Hand
• Organizational vs. market fill rate
• Injectable and alternative utilization
• High-use departments and providers
• Order set and preference list utilization

Follow-up prompts

Surface the next decision as conditions change:

• Inventory risk remains concentrated. Review redistribution?
• Utilization remains elevated. Review additional conservation?
• Days on Hand improved. Maintain current strategy?
• Fill rate recovered. Relax conservation measures?
• Alternative utilization increased. Review impact?
• Supply stabilized. Begin shortage resolution?

• High-priority shortage of LORazepam injection impacting 2 mg/mL vials and cartridges
• Primary drivers: increased demand, manufacturing delays (Pfizer), regulatory delays, and unspecified issues (Fresenius Kabi)
• Shortage may affect inpatient availability and require careful consideration when ordering and prescribing
• Recommended alternatives: oral LORazepam formulations or midazolam as a therapeutic equivalent
• Reference: ASHP Drug Shortage detail – https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=87