Shortage of drugs decried

Top doc says politicians lacked leadership on issue

A nationwide drug-shortage crisis is inflicting “anxiety, pain and harm” on patients across the country, the head of the nation’s largest physicians group is warning.

Appearing before the House of Commons health committee Thursday, Canadian Medical Association president Dr. John Haggie said care is being jeopardized as doctors scramble to source medicines, or find alternatives for drugs that should be in ready supply, “putting patients at risk of relapse and worse.”

Sometimes alternatives can’t be found; other times they’re less effective, more toxic or have been tried before without success, he said.

MPS heard that 65 surgeries have been postponed in the Ottawa region alone and that the number of drug shortages quadrupled between 2006 and 2010.

Haggie took aim at the blame-someone-else response to the shortage from political leaders, saying that the “early finger pointing between governments was anything but a demonstration of leadership.”

“On behalf of the 76,000 doctors represented by the CMA and the millions of Canadians they serve, I have one message for you today,” Haggie said.

“As Members of Parliament, you are among our country’s leaders. At a time like this, when Canadians are facing what is nothing less than a national crisis, they look to you and your peers in legislatures across the country to exercise that leadership and live up to the trust that has been placed in you,” he said.

The shortage is harming not only patients, but also the Canadian economy, Haggie said. “How can it make sense from an economic standpoint to have people ill and off the job because of lack of access to medically necessary therapies?”

He said Canada needs an uninterrupted supply of critical drugs as well as a national monitoring and early notification system for anticipated shortages.

“We rely on the drug companies to tell us. That system, to coin my teenage daughter’s phrase, sucks,” he said. The “allegedly up-to-date” lists supplied are incomplete, and missing drugs that have been in

“There could have been time to stockpile drugs or to arrange supplies from outside Canada.”

DR. RICHARD CHISHOLM

short supply for two or three years, he said.

In a 2011 survey by the CMA, twothirds of doctors who responded said a shortage of generic drugs was affecting patient care.

A drug crisis – expected to last at least a year – was triggered last month when Sandoz Canada Inc. announced it would cancel production of some drugs and slow production of others after a warning letter was issued by the U.S. Food and Drug Administration in November to improve quality-control procedures at the company’s plant in Boucherville. The notice applied to the manufacture of a drug exported to the U.S. and not sold in Canada.

However, Sandoz is the sole supplier to Canadian hospitals of 90 per cent of injectable drugs, medicines used in surgery, emergency and intensive care.

Overall, 70 per cent of drugs used in Canada are either completely or partially manufactured outside the country, the committee heard.

Dr. Richard Chisholm, president of the Canadian Anesthesiologists’ Society, said federal legislation is needed that would place a legal onus on drug companies to immediately warn of any events that might jeopardize drug supplies in order to avoid future “debacles.”

Sandoz didn’t notify its customers of a production interruption until mid-february, said Chisholm, who was speaking from the World Congress of Anesthesiologists in Buenos Aires. “There could have been time for hospitals to stockpile drugs, there could have been time to arrange alternative supplies and other manufacturers, or to source suitable products from outside of Canada,” he said.