Stakeholder Perspectives on the Structural Causes of Drug Shortages in Korea: A Mixed-Methods Study

Document Type : Original Article

Authors

1 Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea

2 Korea Institute for Health and Social Affairs, Sejong, Republic of Korea

3 Department of Health Administration, Kongju National University, Gongju, Republic of Korea

Abstract

Background 
Drug shortages are a persistent global challenge. In South Korea, shortages occur within a distinct context characterized by high import dependence, inflexible pricing structures, and a hospital-centric distribution system. This study examined how frontline pharmacists and policy stakeholders perceive the structural causes of drug shortages across policy, supply-chain, and frontline pharmacy practice levels.

Methods 
We employed a sequential mixed-methods design to triangulate institutional perspectives with frontline realities, comprising six focus group interviews (FGIs) (n = 35) with policy stakeholders and a national web-based survey of 223 licensed pharmacists. Qualitative data explored institutional perspectives on structural causes and policy responses, whereas survey data quantified recent shortage experiences, impacts on patient care, and perceived causes.

Results 
Qualitative findings indicated that stakeholders attributed shortages to structural vulnerabilities, including unprofitable drug prices, dependence on imported raw materials, and distribution rigidities. These perceptions were supported by survey findings and aligned with frontline pharmacists’ reported experiences: 97.3% of pharmacists experienced shortages in the past three months, most frequently involving cold medicines and analgesics. Respondents identified raw material shortages (51.1%) and supply chain imbalances (17.5%) as primary drivers. Although pharmacists used coping strategies such as drug substitution, these adaptations were associated with substantial patient inconvenience (49.3%) and increased pharmacist workload (23%), indicating that individual-level responses are insufficient to address systemic failures.

Conclusion 
Drug shortages in Korea reflect systemic vulnerabilities compounded by distribution constraints rather than temporary disruptions. To address these perceived barriers, we propose a graded policy approach: short-term measures should prioritize administrative flexibility and information sharing, medium-term measures should focus on reforming pricing incentives, and long-term measures should strengthen supply chain sovereignty.

Keywords

References

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History

  • Received Date: 05 September 2025
  • Revised Date: 15 February 2026
  • Accepted Date: 15 March 2026
  • First Published Date: 15 March 2026
  • Published Date: 01 December 2026

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