Global drug shortage hits Canada

ChaoticFate.com by qew
INFORMATION REVOLUTION

May 13, 2011

THERESA BOYLE

HEALTH REPORTER

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An international drug shortage hit home at Princess Margaret Hospital two weeks ago when it was forced to cancel chemotherapy appointments for 10 cancer patients.

In her more than 20 years at the hospital, Esther Fung, head of pharmacy operations, has never encountered a situation where the cupboard has run bare.

“This is the first time we had to cancel appointments because we didn’t have the drug. This is a very challenging time. There are real back-order challenges,” she said Friday.

The drug shortage has been a recurring issue around the world for years. In the last year alone, Canada has struggled with a shortage of many classes of drugs and currently some chemotherapy injectables are in scarce supply.

At Princess Margaret, appointments for the 10 patients had to be moved from a Friday to the following Monday because of a shortage of carboplatin. Cancer Care Ontario insists that short delays in acquiring such chemo drugs, which have also happened at other hospitals, have not affected patient outcomes.

But there is no doubt the shortages are making patients anxious and frustrating health-care providers.

“The concern that is caused by uncertainty of drug supplies is real and it is a concern that we really hope could be reduced or eliminated,” said Dr. Carol Sawka, vice-president of Cancer Care Ontario, noting that the disruption is taking oncologists and pharmacists away from their patients.

The Canadian Pharmacists Association issued a report on the shortage last December, warning that “patients are the ones experiencing the greatest suffering as a result of the drug shortages, principally from the standpoint of health outcomes.”

It warned that some patients are not receiving necessary medications while others, forced to shift to third- or fourth-line alternatives, are not receiving the level of treatment they require.

The global drug supply chain includes raw material suppliers, manufacturers, wholesalers, distributors, pharmacy corporations and individual pharmacists.

Disruptions in any part of the chain can cause shortages. For example, the United States in recent years has tightened quality control measures for imported raw material, or active pharmaceutical ingredients, and that in turn has led to a shortage.

Because drug manufacturers are private, they do not have to share information on supply and manufacturing problems, making it difficult to know when shortages will occur.

The pharmacists’ association is calling for creation of a web-based information system, similar to one in the United States, which would provide information about drugs facing supply constraints.

Health Canada spokesperson Leslie Meerburg said the department is exploring options for improved management of drug shortages.

Illinois-based Hospira, a generic drug manufacturer that includes chemotherapy injectables among its products, is taking steps to address the shortage, said spokesperson Tareta Adams. For example, the company is building additional manufacturing facilities.