National approach can help manage drug shortages in Canada

Canada needs a national approach to managing its supply of pharmaceutical drugs, starting with a mandatory reporting system for drug shortages, argues an editorial in CMAJ (Canadian Medical Association Journal) and CPJ (Canadian Pharmacists Journal).

Shortages of drugs, particularly those used in chemotherapy, as well as antibiotics, antiepileptics and anesthetics, have become increasingly common, unpredictable and widespread in Canada. These shortages result in poorer health for Canadians, with consequences such as worsening of medical conditions, negative reactions to substitute drugs, cancellation of surgeries and procedures, and increased costs to patients and the health care system.

"It is ridiculous and intolerable that a wealthy, developed nation like Canada cannot reliably provide medicines to its people," write Dr. Matthew Stanbrook, Deputy Editor, CMAJ, and Rosemary Killeen, Editor-in-Chief, CPJ.

"Although the causes of drug shortages are myriad and complex, Canada's lack of preparedness for and ability to cope with this problem seem more readily apparent," the authors write. "One salient feature is the absence of integrated, coordinated national leadership on drug policy in Canada."

Europe and the United States require pharmaceutical companies to inform governments in advance of possible drug shortages. Canada, however, is relying on industry to establish a voluntary reporting system rather than establishing a mandatory reporting system.

"A mandatory reporting system for impending shortages should be created and maintained, so that health care stakeholders at all levels have adequate and timely information with which to make decisions," state the authors.

With national leadership to manage the issue, Canada could take other steps to minimize the effect of shortages, including:

• expanding the national pharmaceutical drug stockpile
• mandating that there must be at least two or more suppliers for essential drugs
• establishing a system to share supplies across the country and to restock quickly from international suppliers if there is a shortage.

"The people of Canada deserve greater responsiveness and action from their elected officials to safeguard the supply of some of the most critical components of health care delivery," the authors conclude.