Blogs & Comment

Drug shortage at Canadian hospitals raises questions

That U.S. action is affecting drug availability in Canada is bizarre, but worse is our country's apparent lack of a national strategy to prevent shortages.

A drug delivery shortfall from pharmaceutical firm Sandoz Canada is expected to affect the drug supply (for anywhere from a few weeks to a couple of months) of many common injectable medications in hospitals across the country.

The types of medications include antibiotics, anti-arrhythmics, pain killers, anti-nauseates—bread-and-butter medications which are required everyday in hospitals. Morphine for pain management, Zofran to ease chemotherapy nausea, Amiodarone to stop life-threatening irregular heartbeats, and Valium to help highly anxious psychiatric patients calm down are just a few examples.

This shortfall is due to recent slowdown of production at the Sandoz Canada plant in Quebec. The cause of the slowdown and retooling is unclear, but it was triggered by a November 2011 ‘Warning Letter’ issued by the U.S. Food and Drug Agency.

It’s concerning to me that we have yet another example of supply-chain breakdown in our health care system—several months ago there were shortages of anaesthesia medications which threatened many scheduled surgeries.

Can you imagine automaker GM not knowing the number of bumpers in its supply chain? And then asking workers to substitute Impala bumpers for Malibu bumpers? (Not pretty but it does the job, right?) But as consumers we would never take delivery of such a substitution.

Yet today, we are now asking physicians to change their management protocol with known and reliable drugs and instead use alternative ones which are less predictive in outcomes and perhaps costlier, too.

This most recent situation begs some questions:

1. How does an American agency get involved in halting the production of medications at a Canadian facility? While I’m not averse to U.S. assistance, where is Health Canada on this issue? As a consumer, I’d like to know what is going on inside this plant.

2. Where is a national strategy to monitor medication supplies? Given that our health system is national why don’t we know ahead of time that we are running out of medications? We should know, for example, how many weeks’ worth of necessary drugs hospitals have “in stock.” And there should be a national standard, such as a requirement that there be 20 weeks on hand of drug X and 14 weeks of drug Y.

3. Are buying groups for hospitals a good idea? I can only assume part of the issue here is that groups of hospitals have decided to buy from Sandoz, but when the company cannot supply the drug there are still legal implications that may prevent sourcing alternative supplies from other pharmaceutical companies.

Only the government knows what is really going on here. But I have begun to question whether or not the system knows what the right and left hands are doing. Consumers and physicians want to know what happened here, how we prevent it from happening again and, most importantly, when the shortages will be rectified. 

For now, I suggest you don’t get sick and require hospital care.