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Background and Importance Medicine shortages are a serious obstacle worldwide, particularly in developing countries, which represent small, non-profitable and unattractive markets for medicines, thus highlighting the importance of performing a comprehensive analysis.Aim and Objectives To describe and analyse medicine shortages in Bosnia and Herzegovina (BiH) over an 8 year period.Material and Methods A study was conducted by analysing data on medicine shortages published in the National Register of medicine shortages available on the Agency for Medicinal Products and Medical Devices BiH website from 2018 to 2025. The extracted data were classified using the ATC Classification, the route of administration, duration and reasons for the medicine supply disruptions.Results Out of 844 medicine shortages reported during this 8 year period, 66% corresponded to oral medications, and only 20% to intravenous medications. The shortages primarily involved cardiovascular medicines (17%), nervous system therapeutics (16%), antineoplastic agents (12%), followed by medicines affecting the musculoskeletal system (10%) and antimicrobials for systemic use (10%). The highest number of shortages occurred in 2023 (n=192) and 2024 (n=177), which corresponds to the special report published by the European Court of Auditors. 1 The majority of reported shortages (62%) were only temporary, while 38% were permanent, often due to the non-renewal of a marketing authorisation or withdrawal from the market. The highest number of permanent shortages reported in 1 year was in 2019 (n=61; 74%), while the temporary shortages reached their maximum in the last 3 years, 2023 (n=136; 71%), 2024 (n=132; 75%) and 2025 (n=111; 73%). Commercial reasons were identified as the leading cause of medicine supply disruptions during the entire observed period (n=407; 48%).Conclusion and Relevance A significant increase in reported shortages could be attributed to limited pharmaceutical profitability, inadequate regulatory measures and increased demand for medicines within our economically constrained healthcare system. However, a low number of reported shortages of intravenous medications might imply that marketing authorisation holders have been failing to adequately report existing medicine shortages in hospitals, which highlights the need for a practical framework to address them.References and/or Acknowledgements 1. The European Court of Auditors. Special report 19/2025: Critical shortages of medicines – EU measures were of added value, but structural problems remain. Available at: https://www.eca.europa.eu/ECAPublications/SR-2025-19/SR-2025-19_EN.pdf.Conflict of Interest No conflict of interest