Horne tackles drug shortage
Minister says public won’t have to pay
As Alberta hospitals grapple with a shortage of injectable drugs, Health Minister Fred Horne says the problems should not hit patients in the pocketbook.
Some chemotherapy patients must now buy their own anti-nausea medication from pharmacists because of a nationwide shortage stemming from reduced production at a major Quebec manufacturer of generic drugs. The chemotherapy drugs are covered by insurance companies.
On Wednesday, Horne said the provincial Health Department is working on a plan to make it as “easy as possible” for cancer patients to obtain the drugs.
“The government will not allow Albertans to be out of pocket in any way as a result of the drug shortage from Sandoz Canada,” Horne said.
“I have my department looking at a couple options now for how we will assist people in those circumstances.”
The health minister said he spoke with federal Health Minister Leona Aglukkak Wednesday to urge the fed- eral government to come up with a nationwide strategy to tackle the problems and develop backup supply plans.
Horne said he expects to speak with his provincial counterparts today to talk about joining forces to ensure there’s enough volume to convince alternative companies to produce the drugs.
In the past few weeks, supplies of a number of painkillers, anesthetics and other drugs have dropped to critical levels and Alberta Health Services has been shifting stock around the province to make sure hospitals have an adequate supply.
AHS is also pursuing alternative suppliers and encouraging physicians to conserve drugs such as morphine where appropriate.
No elective surgeries have been cancelled because of the shortages.
Dr. James Silvius, medical director for AHS pharmacy services, says the province aims to have at least a sevenday supply on hand for the 84 injectable drugs Alberta purchases from Sandoz.
One cardiac drug dropped to a one-day supply in Calgary last week, but an internal reallocation shuffled appropriate supplies to the city, he said.
“We so recognize the potential impact on patient care that we’re doing everything we absolutely can think of to ensure patient care,” Silvius said.
Sandoz announced in midFebruary it was slowing or shutting down production of a number of its pharmaceutical products to upgrade its facilities after the U.S. Food and Drug Administration raised concerns.
The delays are expected to last between a year and 18 months.
Some of the pharmaceuticals in short supply are essential, “daily-use” drugs for Alberta’s anesthesiologists, said Dr. Douglas Duval, the Alberta Medical Association’s section head of anesthesiology. Some physicians are concerned about an “information vacuum” on the hospital front lines, leaving them in the dark about which drugs are available and where.
“If we’re going to have a shortage of certain things, we have to make sure we have a ramping up of more than our normal availability of alternatives,” Duval said.
“If we didn’t ramp up with the alternatives when the significant ones are no longer available, it would be a situation where you’d have to look at cancelling elective surgeries,” Duval said.
The province received an emergency supply of some critically short drugs, such as morphine and hydromorphone, last week, said Silvius. Three further shipments are expected in the next few weeks.
The health board has held emergency meetings with doctors to discuss how to handle surgery cancellations, but no elective operations have been halted, he said. “We are not close to that.”
AHS has flagged some international companies that manufacture the needed drugs and asked Alberta Health and Wellness to provide the list to Health Canada to consider speeding up regulatory approval, said Silvius.
The province is particularly short on the injectable form of anti-nausea drug Ondansetron. Chemotherapy patients are now being asked to take the drug orally and purchase the pills from pharmacists so the injectable form is reserved for people who must take it that way, Silvius said. The two forms are equally effective, he said.
Calgary cancer patient Miguel Costa, 40, begins his fifth round of chemotherapy Friday to fight non-hodgkin’s lymphoma. He said he prefers the injectable form of the anti-nausea drug as it begins working much more quickly than the pills. But he said he doesn’t mind taking it orally if necessary, and has no problems paying for the drug at a pharmacy, since it’s covered under his insurance.
“We pay for those benefits. We’re going to have to ask those companies to cough up,” Costa said.
We’re going to have to ask companies to cough up.
CANCER
PATIENT
MIGUEL COSTA