Modeling Bounded Rationality in Drug Shortage Pharmacists Using Attention-Guided Dynamic Decomposition

Abstract

Hospital pharmacists make high-stakes decisions to mitigate drug shortages under uncertainty, time pressure, and patient risk. Interviews revealed that pharmacists focus attention on a small subset of drugs, limiting cognitive effort to the most urgent cases. Motivated by these findings, we formalize a bounded-rational, attention-guided decision framework that dynamically decomposes drugs into a subset for high-cost reasoning and a complementary subset for low-cost monitoring. We develop two agents: an Expert Agent that applies attention weights derived from pharmacist interviews, and a Learner Agent that adapts attention allocation over time through experience. Across simulated scenarios spanning short to long horizons, we show that attention-guided planning supports stable decision-making without complete state reasoning. These results suggest that a primary decision is not what action to take, but where to allocate cognitive effort, and that attention-guided, satisficing strategies can reduce problem complexity while maintaining stable performance.