For most people on methotrexate, however, the pills are well tolerated. David Pisetsky, MD, PhD, a rheumatologist and professor of medicine at Duke University in Durham, N.C., says the shortage hasn’t yet affected his patients, but if it does, he would prescribe the pills.

“If I couldn’t get them the injection, I’d put them on the oral. It’s the same drug,” he says. It might not be as desirable for some patients, but he thinks it would work for most on a short-term, temporary basis.

Addressing Other Shortages

Methotrexate isn’t the only arthritis medication currently affected by shortages. Voltaren Gel, or topical diclofenac – a rub-on nonsteroidal anti-inflammatory medication – was also on the FDA's drug shortage list in early February 2012.

The FDA says there is no easy answer to these shortages.

“The problem of drug shortages is complex and stems from economic, legal, regulatory, policy and clinical decisions that are deeply interconnected,” El-Hinnawy explains. “However, the most common cause underlying most drug shortages relates to problems maintaining high quality manufacturing. While there is no simple solution to resolving drug shortages, we are doing all that we can to make sure patients have access to the critical medicines they need when they need them.”

Late last year, the Government Accounting Office in Washington, D.C., released a report saying the FDA should have more authority to require companies to disclose impending shortages.

“One thing that would be really important is if a company producing the drug [foresees] difficulty with production or distribution, it would be nice to let the FDA and public know that could be a concern,” Dr. Matteson says.

The FDA says there has been progress on this front as a result of an Executive Order the President signed in October. Among other things, it directs the FDA to require drug manufacturers to provide adequate notice of manufacturing discontinuances or other actions that could lead to critical shortages, and it encourages companies to voluntarily notify the FDA about potential shortages. The FDA says it has prevented 114 drug shortages since then, which it attributes to increased voluntary notifications from drug makers. Before the Executive Order went into effect, the FDA says it got about 10 voluntary notifications a month. The month after it was instituted, it received six times as many.