Two ways to fix Canada’s drug shortages problem

One-quarter of over-the-counter and prescription drugs in Canada were “running short” before the pandemic, Dr. Shoo Lee, professor emeritus at the University of Toronto and former pediatrician-in-chief at Mount Sinai Hospital in Toronto, pointed out in a recent article in Maclean’s magazine. Since then, on top of regular shortages, the country has seen shortages of over-the-counter cold medicine for adults, children’s pain and fever reducers, amoxicillin and Clavulin. “There’s nothing quite like a global health crisis to expose a country’s weak points,” Dr. Lee writes. The pandemic also showed how countries reliant on imports are vulnerable during times of crisis. “As we saw with COVID vaccines, countries with their own production facilities will always prioritize getting treatments to their own citizens. If your drug-acquisition strategy relies heavily on imports, as ours does, you need mechanisms in place to protect yourself,” Dr. Lee says. He argues that Canada should have a stockpile of critical drugs that would last at least six months as a short-term solution. The first step would be for Canada to create its list of essential medicines—as the World Health Organization has recommended. The U.S. Food and Drug Administration has already made a list of 227 crucial drugs, which Canada could use as a jumping-off point, Dr. Lee says. He also suggests the list include other things, such as anesthetics, epidurals, antibiotics and drugs used for diagnostic imaging. Read: NOTL pharmacists work overtime to find solutions to drug shortages Then, Dr. Lee says, we should reassess how we stockpile drugs, and begin gathering enough essential drugs to last six months. The Public Health Agency of Canada already manages the National Emergency Strategic Stockpile. However, the pandemic showed it had multiple problems—such as having expired drugs, and not having enough personal protective equipment for healthcare workers during COVID. (The European Union, he points out, is also beginning to make plans for a stockpile.) He says the government should establish a real-time, digital inventory of drugs in the emergency stockpile. That could also create a Crown corporation that would manufacture the essential medicines to make sure the stockpile is always full. That’s the short-term solution; his proposed long-term fix is to work to create a more fulsome pharmaceutical industry in Canada. There are some bright spots in the industry: Moderna began running an operation out of Quebec in 2020, and Mantra Pharma in Quebec has already helped with a shortage by creating a generic as well. Université de Montréal researchers are looking for new ways to make active pharmaceutical ingredients, which are needed to make drugs and also produced overseas. And the generic drug giant Apotex continues to manufacture drugs from its offices in the GTA. Read: Seven ways prescribers can help mitigate critical drug shortages The Canadian government has already faced the issue of being over-reliant on overseas pharmaceutical manufacturers, Dr. Lee points out. That inspired a 1969 change to the Patent Act so Canadian companies could pay royalties to pharmaceutical companies and make patented drugs. That shift led to growth in Canada’s pharmaceutical industry, but that was eventually scuttled by NAFTA and other free-trade agreements. Today, Canada imports most of its drugs once again—the rates have risen from 74% to 93% over the past decade—and the APIs used to make them. That makes us more vulnerable to shortages once again. Being more proactive in our solutions can help avoid these issues. “Young children shouldn’t be running fevers because we can’t secure something as simple as children’s Tylenol, and our solution can’t be to order two million bottles to get parents to stop complaining,” Dr. Lee writes. “We can’t wait for the next war—or pandemic-sized meltdown—to motivate us. We should always be prepared.” Read: Amid U.S. Ozempic shortages, users turn to Canadian pharmacies

Two ways to fix Canada’s drug shortages problem

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