- In September 2026, 70 medicines were in shortage in the US, across 93 manufacturers, and another 179 were being discontinued. Dozens of medicines change status every week.
- Most pharmacies buy the large majority of what they stock from one primary wholesaler. When that wholesaler is out, the pharmacy is out — even when the medicine is sitting in another warehouse.
- There are more than 1,300 licensed wholesale distributor facilities in the US. Many smaller ones exist precisely to carry what the big three don’t.
- Multi-site clinic groups are the best buyers in the market: one decision-maker, many dispensing sites, and orders every month.
01One truck
A pharmacy doesn’t make anything. Almost everything on its shelves arrived on a wholesaler’s truck, and for most pharmacies that’s one wholesaler, on one contract, delivering every day. It’s one of the most dependable buying relationships in any industry.
It also means the pharmacy’s view of supply is that wholesaler’s view of supply. When a pharmacist says a medicine is unavailable, what they often mean is that their wholesaler can’t get it this week. Other licensed distributors may have stock. The pharmacist doesn’t know which ones, and those distributors don’t know the pharmacist is asking.
02A shortage is a moment, not a verdict
When a medicine goes short, it rarely disappears everywhere at once. Supply tightens unevenly: one wholesaler runs out while another still has allocation, a different strength or pack size, or an alternative manufacturer.
That makes the first days of a shortage the moment that matters. The buyer who finds a second source quickly keeps patients on their medicine. The wholesaler who reaches that buyer first wins an account that often stays long after the shortage ends.
03A worked example — the multi-site clinic
Illustrative. A community health centre runs a dozen clinics and an in-house pharmacy. Its purchasing lead orders through one primary wholesaler. A medicine its patients rely on goes short, and the regular order comes back incomplete.
The purchasing lead has two options: wait for the primary wholesaler to recover, or find a second licensed source. The second option is usually faster, but only if they know which distributor to call — and can trust that it’s properly licensed.
For a wholesaler holding that medicine, this clinic group is the best possible buyer: a recurring order, one decision-maker for many sites, and a need with a date on it.
04The missing piece is the introduction
The buyers and the stock both exist. What’s missing is a direct line between a specific clinic or pharmacy that needs a medicine now and a specific distributor that has it. That’s the gap an introduction fills.
What a sharp buyer or wholesaler does now
- Pharmacies and clinics: keep at least one licensed secondary source ready before a shortage, not during one.
- Pharmacies and clinics: know which of the medicines you dispense most are at risk, so a shortage is a phone call, not a scramble.
- Wholesalers: lead with what you can actually ship — specific products, quantities and lead times — rather than a general line card.
- Wholesalers: prioritise multi-site organisations. One conversation with a clinic group can cover many dispensing sites.
The worked example is illustrative and does not describe a specific organisation.
Where Maitex fits
Maitex introduces pharmacies and clinic networks to licensed drug wholesalers. In one case, we found a Texas network of more than 60 clinics and four pharmacies whose supplier couldn’t fill several medications. It needed about 400 bottles a month, and we connected it with a wholesaler.
Buying for a pharmacy or clinic group, or supplying one? Email zishaan@maitexai.com.