Canada's drug shortage

It may not be critical yet, but this year's shortage of flu vaccine and other drugs is a sign of things to come

By: Lanny Boutin

  Canada is experiencing a significant shortage of vaccines and other important drugs this winter. Mergers, raw material shortages, factory problems and drugs being discontinue because they're unprofitable all contribute to this increasing trend which could ultimately affect the health of Canadians.
  Last year it was Penicillin G and its cousins Ampicillin and Cloxacillis. This winter Canadian drug companies could not cover the growing demand for the flu vaccine.
  "Drug shortages have become a more frequent issue," notes Michael Kozuska, coordinator of purchasing and inventory control for Capital Health's regional pharmacy services. "We don't measure the frequency of shortages explicitly. However we've been more involved with shortages in the last one to two years then we were five years ago."
  "From a hospital perspective we have a number of injectables, many very critical drugs, that have been in short supply" notes Linda Poloway, president of the Canadian Society of Hospital Pharmacists.
 

By scrambling and improvising, Canada's health care workers have avoided a crisis - so far

  Director of regional pharmacy services for the David Thompson Health Region, Poloway notes that even though shortages haven't threatened lives in her region, they do cause "a lot of work, tracing products, finding alternatives and communicating to everybody, what those alternatives are."
  Health Canada does not maintain drug shortage records, but a recent poll by the Infectious Diseases Society of America found that of the 492 members who responded, 324, or 66 percent said they had encountered antimicrobial shortages in the 3 months prior to the survey.
  The US Food and Drug Administration (FDA) recently set up a web page to alert the public, as well as doctors, to shortages of medically necessary drugs. As well as current shortages, it lists drugs which are in limited distributions and those which are back on the market.
  The recent Canadian shortages of Penicillin G, Ampicillin and Cloxacillis were caused by a raw material shortage. In the US a shortage happened after one of the manufacturers voluntarily recalled and ceased distributing Penicillin G after an FDA inspection of one of its plants.
  Sometimes "products are discontinued because of poor market," notes Poloway. "The bottom line is profit. If they are not large profit-generating items they are simply discontinued, regardless of their niche in the market as a necessary product".
  Preven, the first morning-after pill in Canada, was recently pulled off the Canadian market by the manufacturer, Shire Inc. Even with price reductions from $22 to $5, Canadian sales were 90 percent below company projections.
  "As more drug companies merge, more product rationalization or streamlining takes place and the number of alternative choices that might be available in the marketplace is reduced," notes Kozuska.
  New or innovative therapy can result in larger demand for specific drugs. More companies vaccinating their employees, as well as the Ontario Government's decision to supply free flu vaccinations to all residents helped deplete this years supply of flu vaccine, even though the Canadian manufacturer, BioChem, had raised production by one million doses.
  When disease or therapy patterns change, production facilities need time to react, something that's not always possible with the many layers of government regulation that drug companies work under.
  By cutting back on dosages, trading, lending or working with doctors and suppliers to find alternatives, hospitals have so far kept patient inconvenience minimal. As Poloway notes, though, "the options become fairly limited when we are all in the same boat."

Lanny Boutin is a freelance writer living in Gibbons, Alberta. She can be reached at www.ecn.ab.ca/~lanny

Sites to check out:
U.S. Food and Drug Administration Drug Information page www.fda.gov/cder/drug/shortages

Infectious Diseases Society of America www.idsociety.org/NewsRoom/...

Posted: February 05, 2001

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