Hospitals spend roughly $230 million a year on expensive generic substitutes in an effort to combat drug shortages, according to new research from Premier, Inc. But the financial impact is probably higher, because the research didn't include drugs that hospitals purchase from off-contract distributors or those with therapeutic alternatives, according to the study. The most common shortages of drugs include electrolytes, IV fluids and parenteral nutrition, cardiovascular agents used to treat heart disease and other cardiac conditions, and surgical agents used for surgery prep, anesthesia and sedation. Study (.pdf)