Drug shortages will continue without innovative solutions: expert
OTTAWA – Shortages of drugs that treat breast cancer and childhood leukemia have gotten much of the attention lately, but they represent just a small fraction of all the drug shortages in Canada right now. And such shortages will continue unless dramatic changes are made, says a Canadian drug policy expert.
Jacalyn Duffin, professor emerita at Queens University who held the Hannah Chair for the History of Medicine until 2017, said the federal government has to do a better job of measuring and understanding the cause and the scope of drug shortages.
“We cannot talk about the drug shortage problem until we know what it is and how it changes over time.”
In 2018, Duffin and colleagues produced a report published by the C.D. Howe Institute that assessed Canada’s drug shortage problem. At the time, they recommended Health Canada provide annual reports on drug shortages in an effort to “define it, explain it and help provide solutions to mitigate the risks associated with the shortages.”
The authors also recommended Health Canada measured the medical necessity of drugs to help prioritize solutions to shortages and that Canada encourage increased self-reliance in the manufacture of drugs and active ingredients in drugs — meaning produce its own.
In an interview, Duffin noted that Health Canada is still not measuring and analyzing drug shortages.
In an update on tamoxifen shortages, Health Canada said it assesses the severity and potential impact of drug shortages when they occur.
“Many shortages can be resolved through supply management measures without their effect ever being felt by patients. Health Canada works closely with the Canadian companies that supply drugs, the provinces and territories, and health stakeholders across the supply chain to identify and facilitate mitigation measures, as needed.”
Along with a better understanding of the scope of ongoing shortages, she said, Canada should consider making its own generic drugs and drug ingredients as a buffer against some shortages.
“It blows me away that in a country like Canada with intellectual capital and human resources, we don’t just start making them.”
In the U.S., a group of hospitals and medical insurance groups formed a non-profit generic drug manufacturing company out of frustration over continuing shortages.
Canada has a mandatory drug shortage and discontinuation database, drugshortagescanada.ca, which is operated by Bell Canada under contract with Health Canada. According to the website, there are currently 1,966 drug shortages and 52 anticipated drug shortages in Canada. The site lists, but does not analyze the shortages.
Among drugs that continue to face shortages are tamoxifen, commonly prescribed for women with estrogen positive breast cancer. For weeks, patients have reported difficulty filling their prescriptions.
Apotex, which is the country’s biggest supplier of tamoxifen, expects to have supply available “as soon as possible,” said vice-president Jordan Burman.