Skip to content
Today’s pharmacy is nothing if not resilient, as demonstrated by the growing use of alternative medications to address drug shortages and other types of supply chain disruptions. Whereas in the past a disruption would have a debilitating effect, pharmacies now have options for offering alternative conventional medications along with therapies that fall outside what is considered “mainstream medicine.”
To be successful, though, pharmacies need reliable access to alternative medications, including the ability to identify suppliers with medications in stock. Pharmacists also need to manage inventory holdings along with transaction details and records. Otherwise, a pharmacy risks sourcing delays, lost revenue, and patient dissatisfaction. As we’ll see, an integrated technology system, such as PrimeRx, will seamlessly manage a pharmacy’s alternative medication practices and help ensure patients leave the pharmacy with the medications they need.
Table of Contents
What Are Alternative Medications and Why Do They Matter?
In terms of daily pharmacy activity, “alternative medicine” refers to options available when a prescribed drug is unavailable or inaccessible due to cost considerations, allergies, and other factors. This list typically includes:
- Generic substitutes
- The Food and Drug Administration (FDA) defines a generic drug as “a copy of a brand-name drug that is developed and made by a company other than the company that makes the brand-name drug.” Generics have the same active ingredients, conditions of use, and dosage as brand-name drugs, but include “certain minor differences” such as different inactive ingredients. According to the National Community Pharmacists Association (NCPA), generic drugs account for 84% of medications dispensed annually by community pharmacies.
- Therapeutic alternatives
- Medications approved to treat the same conditions and/or diseases.
- Compounded medications
- Medications that are custom-made for patients unable to take prescribed medications due to allergies and other conditions. Compounded drugs are not FDA-approved.
- Biosimilars
- Medications that are highly similar to FDA-approved biologics. Biosimilars can be compared to “generic versions of biosimilars,” but, because these medications are made from biological materials, rather than chemicals, it is impossible to make an exact match of a biologic.
But “alternative medicine” also has meanings that extend beyond pharmacy medication options. According to Medical News Today, the term refers to a broad range of medical systems and practices “that are outside mainstream medicine,” and typically do not have the high degree of scientific basis and validation as conventional medicine. Common categories include:
- Complementary and Alternative Medication (CAM)
- The National Center for Complementary and Alternative Medicine (NCCAM) defines CAM as “a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.”
- ‘Complementary’ medicine refers to treatments used together with conventional medicine, whereas ‘alternative’ medicine is used in place of conventional medicine.
- Examples of CAM therapies/practices include energy healing, massage therapy, yoga, hypnosis, tai chi, herbal supplements, dietary supplements, nutraceuticals, and functional foods.
- Integrative Medicine
- The Mayo Clinic describes integrative medicine as an approach that combines conventional medicine with complementary treatment “to provide the right care for each person.” Integrative medicine is used to promote health, help patients manage symptoms, and improve their quality of life.
- Examples of treatments include acupuncture, massage therapy, meditation, resilience training, and stress management.
The FDA notes more than one-third of American adults have used “some form of CAM,” and that visits to CAM providers exceed visits to primary care providers. For many patients, CAM is a worthy option, with treatment plans personalized to address each patient’s unique situation, including consideration of alternative medications when appropriate.
For purposes of this discussion, though, alternative medication will focus on options available to overcome increasingly common drug shortages and supply disruptions.
What’s Driving the Need for Alternative Medications in Pharmacies?
In May 2026, the American Society of Hospital Pharmacies (ASHP) had almost 190 drugs listed on its official “Drug Shortage” list. Although that number was down from past years, it points to a continuing trend. The number and scope of drug shortages have become so serious that the American Medical Association (AMA) declared the issue to be “an urgent public health crisis and a national security threat.
The FDA cites several factors driving drug shortages:
- Requirements related to FDA manufacturing compliance.
- Active or inactive ingredient shortages.
- Regulatory delay.
- Discontinuation of the manufacture of a drug.
- Supply chain issues (most drugs are manufactured outside of the U.S.).
- Increased demand for a drug.
Regardless of the reason, the impact of an inaccessible medication can be severe, especially when pharmacies must quickly evaluate alternative medications to avoid delays in care.
How Can Pharmacies Identify Reliable Alternative Medications?
Pharmacists have a strong interest in ensuring that patients leave the pharmacy with appropriate medications – even when the exact prescribed drug is not available. Several resources are available to alert pharmacies about medications in short supply and to identify suitable alternatives. Important resources include:
- FDA Drug Shortages List. Provides real-time status reports on all “medically necessary” drugs, deemed to have the greatest impact on public health.
- American Society of Hospital Pharmacies (ASHP). Provides a more expansive listing of shortages than the FDA and relies on different criteria for determining when a shortage has occurred.
- Wholesalers/Suppliers. Wholesalers and suppliers maintain listings of drug shortages. Access to these listings is typically restricted to contracted healthcare entities with proper credentials.
- State Pharmacy Boards. Pharmacies can also consult their state pharmacy association for a state-specific listing of drug shortages.
Resources to assist in identifying viable alternatives include:
- FDA Orange Book: Officially called the “Approved Drug Products with Therapeutic Equivalence Evaluations,” this is a listing of approved therapeutic alternatives for brand-name drugs as well as generics.
- FDA Purple Book: Listing of approved biological products, along with “biosimilar and interchangeable products.”
- American Society of Hospital Pharmacies (ASHP): The previously-mentioned ASHP drug shortage list offers information about alternatives for medications included on the list.
Building a Sourcing Workflow for Alternative Medications
While the resources listed above help identify drug shortages and suggest alternatives, a pharmacy must also have a sourcing network in place to ensure reliable, fast access to alternate drugs when needed.
This often means expanding a supplier network to include secondary and even tertiary wholesalers. Healthcare professionals and pharmacy teams will want to vet any potential supplier to verify compliance and capabilities. That vetting process should take place well before an alternative drug is needed, so that a relationship is established and the groundwork laid for immediate order processing.
Create a Drug Shortage Response Protocol
Supplier identification should be part of an overall pharmacy response protocol. This written protocol should be shared with employees and serve as a quick reference whenever a prescription arrives for a drug that is unavailable. Essential steps should include:
- Internal process for determining if a drug is unavailable (i.e., check FDA and ASHP listings).
- Designate responsibility for contacting suppliers and notifying prescribers.
- Identify all documentation and compliance considerations.
- Maintain a preferred alternatives list:
- Ensure viable options by drug class.
- Ensure the list is regularly updated and that supplier contact information is accurate.
- Evaluate pharmacy management software to identify options for automating this and other key processes.
Leverage the Power of Technology
The importance of technology in managing the procurement and administration of alternative medications cannot be overstated. A comprehensive system, such as PrimeRx, includes functionality that automates and facilitates every part of the process. A few PrimeRx capabilities include:
- Direct integration with all suppliers for seamless access and inventory management.
- Direct integration with Red Sail RxMARKET, which is a leading online marketplace for medications and other pharmacy supplies. Pharmacists have direct access to dozens of wholesalers and suppliers. The system searches in real time for required medications and, once viable options are identified, generates a side-by-side cost comparison. The system also identifies NDCs and alternative medications that may be available at a lower price. Pharmacists can submit orders with multiple providers, all without having to leave their dispensing workflow.
- Inventory Alerts – An alert is generated whenever a medication level reaches a certain pre-set level. This serves as an “early warning” that a pharmacy is at risk of running out of a certain medication, and seamlessly submits an order to the appropriate supplier.
- Prescription processing tools that accommodate therapeutic alternatives.
- Compliance capabilities include drug interaction checks, refill authorization, and documentation of substitution decisions.
- Communication capabilities that allow seamless exchange of information with patients, as well as prescribers and payers.
Alternate medications are an important part of today’s pharmacy practice. By offering patients viable options when a prescribed medication is unavailable, pharmacists benefit by “saving the sale” and demonstrating concern for patient well-being. At the same time, patients leave the pharmacy with needed medications, content in knowing their pharmacist went the extra mile on their behalf.