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OmniRx › Drug data › Methotrexate

Drug data · shortage, price, volume

Methotrexate injection: 43 months on the FDA shortage list while the generic benchmark price fell 27% since 2021

The FDA says supply is short. The pharmacy benchmark says the generic injectable now costs $1.75 per mL, against $2.19 in 2013. Both are true, and they measure different things: availability on one side, the average price pharmacies pay on the other.

FDA shortage list, 2026-10-27NADAC, October 2026Medicaid SDUDinferred monthno data
  1. The injectable has been on the FDA list continuously since April 2023, 43 months. Before that it was listed from May 2017 to December 2019, so it has been listed in 75 of the 114 months since May 2017.
  2. Only 24% of shortage listings since 2014 have lasted this long. The median listing lasts 20 months.
  3. A generic 25 mg/mL injectable costs pharmacies $1.75 per mL on the NADAC benchmark in October 2026, 27% below its 2021 median.
  4. Medicaid paid for 16,050 injectable prescriptions in Q4 2025, 27% fewer than in Q4 2021. Fills fell across a stretch in which the injectable was listed as short in 75 of 114 months.

Not medical advice. This page reports public records about supply and pharmacy cost. Ask a pharmacist or prescriber about your own medication.

Three clocks on one timeline

Each lane uses the same monthly axis, so you can read across: when the FDA listed the injectable, what pharmacies were paying, and how many Medicaid prescriptions were filled.

on the listinferred across a missing captureno capture or no price$ per mLprescriptionspreliminary quarter

Swipe the chart sideways to see all 14 years.

Three clocks: FDA shortage list, pharmacy acquisition cost and Medicaid prescriptionsShared monthly timeline. Top lane: months the injectable was on the FDA shortage list. Middle lane: NADAC price per mL by strength. Bottom lane: Medicaid prescriptions per quarter. 2014201520162017201820192020202120222023202420252026FDA shortage listinjectable, by name2013-01 to 2014-05: no capture of the FDA list for these months2014-09 to 2014-09: no capture of the FDA list for these months2016-02 to 2016-02: no capture of the FDA list for these months2017-05 to 2018-09: on the list (observed)2018-10 to 2018-11: on the list (inferred across a missing capture)2018-12 to 2019-01: on the list (observed)2019-02 to 2019-04: on the list (inferred across a missing capture)2019-05 to 2019-12: on the list (observed)2023-04 to 2024-09: on the list (observed)2024-10 to 2025-08: on the list (inferred across a missing capture)2025-09 to 2026-10: on the list (observed)first listed May 2017current run since April 2023Pharmacy costNADAC, $ per mLbold = 25 mg/mLgeneric$0$2$4$2.19 in 2013$1.75 nowMedicaid fillsprescriptions per quarterinjectable2013Q1: 7,810 prescriptions; unsuppressed state rows only2013Q2: 8,331 prescriptions; unsuppressed state rows only2013Q3: 8,816 prescriptions; unsuppressed state rows only2013Q4: 8,945 prescriptions; unsuppressed state rows only2014Q1: 8,934 prescriptions; unsuppressed state rows only2014Q2: 11,282 prescriptions; unsuppressed state rows only2014Q3: 13,098 prescriptions; unsuppressed state rows only2014Q4: 14,247 prescriptions; unsuppressed state rows only2015Q1: 13,797 prescriptions; unsuppressed state rows only2015Q2: 14,868 prescriptions; unsuppressed state rows only2015Q3: 14,382 prescriptions; unsuppressed state rows only2015Q4: 14,576 prescriptions; unsuppressed state rows only2016Q1: 16,738 prescriptions; unsuppressed state rows only2016Q2: 15,677 prescriptions; unsuppressed state rows only2016Q3: 15,212 prescriptions; unsuppressed state rows only2016Q4: 16,205 prescriptions; unsuppressed state rows only2017Q1: 16,179 prescriptions; unsuppressed state rows only2017Q2: 17,007 prescriptions; unsuppressed state rows only2017Q3: 15,981 prescriptions; unsuppressed state rows only2017Q4: 15,223 prescriptions; unsuppressed state rows only2018Q1: 14,541 prescriptions; unsuppressed state rows only2018Q2: 15,326 prescriptions; unsuppressed state rows only2018Q3: 15,785 prescriptions; unsuppressed state rows only2018Q4: 18,511 prescriptions; unsuppressed state rows only2019Q1: 19,028 prescriptions; unsuppressed state rows only2019Q2: 20,972 prescriptions; unsuppressed state rows only2019Q3: 21,271 prescriptions; unsuppressed state rows only2019Q4: 20,941 prescriptions; unsuppressed state rows only2020Q1: 21,663 prescriptions; unsuppressed state rows only2020Q2: 20,248 prescriptions; unsuppressed state rows only2020Q3: 21,270 prescriptions; unsuppressed state rows only2020Q4: 21,314 prescriptions; unsuppressed state rows only2021Q1: 21,775 prescriptions; unsuppressed state rows only2021Q2: 21,958 prescriptions; unsuppressed state rows only2021Q3: 22,081 prescriptions; unsuppressed state rows only2021Q4: 21,922 prescriptions; unsuppressed state rows only2022Q1: 21,634 prescriptions; unsuppressed state rows only2022Q2: 24,246 prescriptions; unsuppressed state rows only2022Q3: 24,348 prescriptions; unsuppressed state rows only2022Q4: 22,087 prescriptions; unsuppressed state rows only2023Q1: 21,888 prescriptions; unsuppressed state rows only2023Q2: 17,904 prescriptions; unsuppressed state rows only2023Q3: 16,819 prescriptions; unsuppressed state rows only2023Q4: 16,583 prescriptions; unsuppressed state rows only2024Q1: 16,846 prescriptions; unsuppressed state rows only2024Q2: 16,417 prescriptions; unsuppressed state rows only2024Q3: 16,198 prescriptions; unsuppressed state rows only2024Q4: 16,389 prescriptions; unsuppressed state rows only2025Q1: 16,720 prescriptions; unsuppressed state rows only2025Q2: 16,792 prescriptions; unsuppressed state rows only2025Q3: 16,829 prescriptions; unsuppressed state rows only2025Q4: 16,050 prescriptions; unsuppressed state rows only2026Q1: 14,531 prescriptions (latest quarter, preliminary: CMS may revise); unsuppressed state rows only24k0
Top: months the injectable name was on the FDA list (Wayback captures of the FDA page; the current FDA record says posted 2023-03-13). Middle: NADAC per mL, one line per strength. Bottom: Medicaid prescriptions per quarter. Medicaid volume: 64,741 rows pulled for this drug, 31,840 (49%) suppressed by CMS for small cells and left out, never counted as zero, so every bar is a floor; state XX national rows excluded; the hatched latest quarter is preliminary. Fills also move with Medicaid enrollment, so a change is not by itself evidence of a shortage.

How long do shortages last?

Each step is a drop in the share of FDA shortage listings still running. The dot is this drug.

Share of FDA shortage listings still running after N months, with this drug marked0%25%50%75%100%024487296120months on the FDA listmedian 20 monthsthis listing: 43 mo24% lasted this long
Kaplan-Meier on 430 listings, 2014 to 2026, by ingredient. 18 months have no capture and are bridged by inference.

What a pharmacy pays per unit

NADAC is the average price retail pharmacies pay, per mL.

Pharmacy acquisition cost per unit, brand against genericInjectable 25 mg/mL$1.75
NADAC prices this form per mL. It is acquisition cost, not a retail price.

Which forms are short

FDA listing by dosage form
FormListed nowMonths listedFDA records (2026-10-27)
injectableYes, since April 2023434 unavailable, 2 limited availability, 8 available (14 records)
tabletNo (last listed July 2024)12none
oral liquidNo0none

Price by strength

Injectable: generic acquisition cost per mL by strength
StrengthNow2021 medianFirst monthNow vs 2021HistoryNDCs
25 mg/mL$1.75$2.40$2.192013-11-27%10
Tablet: generic acquisition cost per tablet by strength
StrengthNow2021 medianFirst monthNow vs 2021HistoryNDCs
2.5 mg$0.163$0.340$2.242013-11-52%16
Read the price with care. NADAC is a national survey average of retail pharmacy invoices. It is not a quote, not what any patient paid, and it excludes discounts and rebates. A flat or falling benchmark during a shortage means pharmacies' average invoice cost did not rise, not that every patient could find the drug at that price.
FDA caution. The FDA drug shortage list is updated as manufacturers report and should not be relied on for medical care. Ask a pharmacist or prescriber about supply.

Questions

Is Methotrexate still in shortage?

On the FDA list as of 2026-10-27, the injectable is listed under 14 presentations: 4 unavailable, 2 with limited availability and 8 available. It has been continuously listed since April 2023. FDA says not to rely on the list for medical care; ask a pharmacist.

Did the shortage raise the pharmacy price?

Not in the benchmark. The NADAC survey average for a generic 25 mg/mL injectable is $1.75 per mL in October 2026, 27% below its 2021 median and 20% below November 2013. NADAC is a national average of retail pharmacy invoices, so it measures what pharmacies pay on average, not what any one patient was charged.

Did Medicaid fills fall during the shortage?

Yes. CMS State Drug Utilization Data shows 16,050 Medicaid-paid injectable prescriptions in Q4 2025, 27% fewer than in Q4 2021 (21,922). Those counts are a floor because CMS suppresses small cells, they cover Medicaid only and move with Medicaid enrollment, and they count prescriptions that were filled, not demand that went unmet. A change in fills is not by itself evidence of a shortage.

Cite this page

Figures are calculated from U.S. federal sources (see Data terms below) and rebuilt from dated snapshots. Cite it as:

OmniRx, "Methotrexate: FDA shortage, NADAC acquisition cost and Medicaid utilization", data as of October 2026. https://omnirx.org/drugs/methotrexate

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Sources

Data terms. Every source above is published by a U.S. federal agency (CMS or FDA). CMS's data site labels its datasets inconsistently: of the 14 NADAC years, 5 carry the "public domain" label and 9 the "U.S. government works" label; of the 14 State Drug Utilization Data years, 6 carry the "public domain" label and 8 the "U.S. government works" label. We record each dataset's label verbatim and cite the source for every figure. Figures on this page are OmniRx calculations from those datasets, not statements by CMS or FDA, and no agency endorses this page.