I do the buying for a pharmacy. We have been dealing with serious drug shortages for over 16 months now. We have had problems getting electrolytes for TPN,s H2 blockers, anti-emetics, chemo drugs (lots more than just methotrexate). Now we are trying to find Lidocaine and Marcaine. Better not need any local antistetic. The one thing that we have noticed, is that when the product does show up back on the market, the price (cost to us, which we are going to pass on) is about 30% higher or more.
The FDA can't do crap about it. Where there use to be 3-4 manufactures of a certain product, it is down to 1. If there is ANY issue in the plant, from a bad batch of glass vials or stoppers, or a bad lot, it affects the entire supply chain. A spot shortage expands to a nationwide shortage. Causes facilities to hoard. Then patients can't get the meds that they need. You scramble to borrow, or beg.