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Description: Objectives The number of medicines reported under short supply has increased. We analyze how shortages led to changes in access to and expenditure for pharmaceutical care in the Swiss health system between 2015 and 2020. Methods We combined cross-sectional and longitudinal data to study medicine shortages by incidence, duration, intensity, and the effect on pharmaceutical expenditure. We assessed 4,119 markets defined by active ingredient, dosage form, and strength. We classified markets by essential medi-cine status and other characteristics. We differentiated shortages by the degree to which alterna-tive options are still available. We investigated the proportion of medicines for which a shortage was reported during the first lockdown period of the COVID-19 pandemic, considering COVID-19 specific medicines. Results 1,964 markets never reported a shortage. 1,336 reported partial shortages. 819 markets reported shortages lasting at least 14 days. Markets with a higher number of manufacturers, a lower co-payment share, and lower prices more frequently reported shortages. We did not find differences by essential medicine status. In 50% of instances, the average price of substitutes available is low-er than the price of the product on shortage. The total pharmaceutical expenditure attributed to shortages increased by CHF 17.00 million (€15.63 million) in 2018. Conclusions Medicine shortages have substantially reduced access to pharmaceuticals. Switzerland has experi-enced shortages on a scale similar to that in other countries. Prices of substitutes available at time of shortages can be higher or lower, thereby indicating an unelastic demand for medicines.