In 2023, nearly 3,000 drug shortages were reported in Canada. Or more than 20% of products approved in the country, data from La Presse shows.
Posted at 5:00 am.
“There has been a constant shortage in Canada for 10 years. It is really incredible. It is surreal to see the amount of products that are constantly entering a critical situation and becoming scarce,” says Jean-François Bussières, clinical professor at the Faculty of Pharmacy at the University of Montreal and former head of the pharmacy department at CHU Sainte-Blandine. Justine.
As of December 29, 2,975 drug shortages have been reported in Canada in 2023. While in the past we occasionally struggled with drug shortages, today they are a daily challenge, emphasizes Bussières.
PHOTO PATRICK SANFAÇON, LA PRESS ARCHIVE
Jean-François Bussières, clinical professor at the Faculty of Pharmacy at the University of Montreal
Today in a large pharmacy department [d’un hôpital]there is almost a full-time person taking care of it.
Jean-François Bussières, clinical professor at the Faculty of Pharmacy at the University of Montreal
From 2017 to present, an average of 1,878 of the 9,343 prescription drugs sold were affected by a shortage each year, according to Health Canada data obtained by La Presse. That's more than one in five medications.
According to the Canadian Pharmacists Association, no less than 20% of a pharmacist's working time is spent managing medication shortages. This involves informing patients and healthcare teams, finding new sources of care and developing alternative solutions. “We are careful to minimize the impact. It’s not visible, but it’s a lot of work,” says Diem Vo, head of the pharmacy department at the CISSS de la Montérégie-Est.
Thousands of bottlenecks
“There are always a lot of bottlenecks. The pandemic has really highlighted the fragility of the supply chain,” says Geneviève Pelletier, senior director, Pharma Service, at the Quebec Association of Pharmacist Owners.
According to Health Canada, the average duration of each shortage in 2022-2023 was 98 days, or more than three months.
These disruptions to care place significant pressure on the healthcare network. Twice a month, an information bulletin is sent to health facilities in Quebec to inform them of medicines affected by supply difficulties. “In 2021 we had a three or four page document. We now have a document of about 15 pages. There are more and more of them and they are becoming more and more worrying and critical for customers,” says Diem Vo, President of the Executive Committee for Pharmaceutical Acquisitions (CEAP) of the Table of Heads of Pharmaceutical Departments.
In addition, some are concerned that American authorities are allowing certain states to import drugs south of the border, most notably Florida, which received the green light on Friday.
“Canada simply cannot supply medicine to Florida or any other U.S. state without significantly increasing the risk and severity of drug shortages in the country,” said David Renwick, interim president of Innovative Medicines Canada, an advocacy group that represents pharmaceutical companies.
For his part, Federal Health Minister Mark Holland wanted to reassure people. “I want to make sure [aux Canadiens] that they continue to have access to the medicines they need, when they need them,” he said, adding that “strict regulations are in place to protect supplies.”
Health Canada then clarified that regulations have been implemented under the Food and Drugs Act to “prohibit the sale of certain drugs intended for the Canadian market for consumption abroad if such sale causes or worsens the risk of drug shortages in Canada.” “Mass importation will not be an effective solution to the problem of high drug prices in the United States,” the department also said.
Impact on the population
Mathé-Manuel Daigneault finds himself reluctantly dealing with the consequences of recurring lack of injectable testosterone, a treatment used by many trans men.
“I've been taking it for almost 10 years and I've lost count of how many stocks I've experienced in that time,” he admits. Some of the worst shortages in recent years have spanned several months.
These shortages involve switching from one type of testosterone to another. “However, some people react negatively to either solution,” he says. This is his case. He is allergic to one of the two products available. It is not uncommon for a shortage of one to be quickly followed by a shortage of the other, fueled by increasing demand.
“There is definitely the option of freezing or [timbres]but their price is much higher, not to mention the need to apply the gel daily and the risk of transmitting the dose to anyone with whom we have skin contact in the hours after application,” he says.
Looking for alternatives
Behind the scenes, pharmacists are working to mitigate the impact on the population, particularly by working closely with suppliers. They also have to “help patients search [solutions de rechange] and take care of their concerns,” says Ms. Pelletier.
PHOTO FRANÇOIS ROY, THE PRESS
Diem Vo, Head of the Pharmacy Department of the CISSS de la Montérégie-Est
If there are no alternatives, pharmacists sometimes have to contact Health Canada or the poison control center to change the expiration date of medications until supplies are replenished or an alternative solution arrives, explains Diem Vo.
Drug shortages can also cause additional costs. Substitution treatments are sometimes more expensive, which increases the bill for both patients and the Régie de l'assurance santé du Québec (RAMQ), explains the general director of the Quebec Association of Pharmacy Distributors (AQDP), Hugues Mousseau.
PHOTO HUGO-SÉBASTIEN AUBERT, THE PRESS
Ozempic pen boxes
Carole Chapdelaine has been faced with this reality since September. The 4 mg Ozempic pen she uses every month is sold out. She is therefore required to purchase two 2 mg pens for the same period. Because the pens were the same price regardless of dose, the cost of his treatment increased from $238 per month to $476 per month. “I am outraged that the pharmaceutical company is profiting from the shortage it has caused. It’s shameful,” she laments.
In collaboration with Vincent Larin, La Presse
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1 in 4 people Percentage of Canadians who have personally experienced a drug shortage or know someone who has
Source: Canadian Pharmacists Association