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Which of the following factors is most likely to contribute to a widespread shortage of a pharmaceutical product?

  1. Lot recall

  2. Patent expiration

  3. De-listing by provincial drug plans

  4. Lack of raw material

The correct answer is: Lack of raw material

If a pharmaceutical product lacks the crucial raw material required for its production, it is highly likely to contribute to a widespread shortage. Lot recall (choice A) refers to the removal of specific batches of a product due to quality control or safety concerns, and would not necessarily result in a widespread shortage. Patent expiration (choice B) may lead to increased availability of generics, but not necessarily a shortage. De-listing by provincial drug plans (choice C) may impact accessibility and affordability, but would not directly cause a widespread shortage of a pharmaceutical product. Only choice D directly relates to the production and availability of the product itself, making it the most likely factor to contribute to a widespread shortage.