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Supply-line disruptions could cause Canadian drug shortage

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OTTAWA — Canadians should brace for drug shortages as COVID-19 disrupts global supply lines, the federal health ministry's top public servant says.

A lack of medications to fill ordinary prescriptions is an ongoing issue in Canada, but deputy health minister Stephen Lucas says COVID-19 is worsening the problem.

"We anticipate there will be shortages of health products given the global demand," he told the House of Commons health committee.

The government has a team dedicated to addressing the problem, he said.

A large majority of pharmaceuticals, and key ingredients for drugs made elsewhere, come from China and India, according to the Canadian Pharmacists Association. COVID-19 has disrupted operations in those countries so much, nations across the world are finding the global supply chain stretched.

"What we're going to see in the next month or so is the effects of the shutdown in China," said the association's spokesperson Barry Power.

Pharmacists have also seen shortages related to people stockpiling their prescribed medication, putting future supply in jeopardy, Power said.

There was a huge rush in March as people tried to secure their medications as physical distancing measures were put in place, with some people requesting six-month supplies, he said.

Over-the-counter drugs like acetaminophen, or Tylenol, have been in short supply for the same season.

Wholesalers began to warn the demand was not sustainable, especially considering the pressure on the supply chains.

Certain medical devices, like thermometers, are also in short supply due to global demand.

Pharmacists decided to take measures after watching the toilet-paper fiasco unroll, Power said, and the pharmacists' group has recommended limiting patients to a one-month supply of their medications to try to prevent shortages.

Health Canada has asked Canadians not to stockpile drugs.

Pharmacists are particularly worried about patients who are on medications to treat heart conditions, asthma, other lung conditions and diabetes, since they are likely to wind up in hospitals if they can't get their prescriptions filled.

Lucas said the government's dedicated group is working with regulators in the United States, Australia and Europe to try to spot where the supply-chain disruptions are likely to occur, and what impact they might have on pharmaceuticals and medical equipment.

"In addition, steps are taken to find substitutes and allow for the importation of other products that can help address it," Lucas said.

Last week the House of Commons passed a massive bill giving the government the power to respond to the COVID-19 outbreak, including measures to prevent drug shortages.

The government has essentially given itself the power to pass any new regulations it considers necessary to prevent or alleviate shortages, but has not revealed what those might be.

The government has also given itself the authority to allow manufacturers to make products needed during the health crisis, regardless of patent protections. That would allow more manufacturers to make drugs that are in short supply.

But there's only so much that can be done when drugs and their key ingredients are scarce across the globe, said Power.

For instance, the government could expedite approvals for alternative medications that are already approved in countries with similar standards to Canada's, but Canada would still have to compete with those countries for supply.

Officials could increase local production of in-demand drugs, but if the key ingredients aren't available that won't do much good, either.

While the full impact of the supply-line issues hasn't yet been felt yet in Canada, Power said he expects it to happen within the month.

It will only get worse if COVID-19 infiltrates wholesalers' workforces, which could mean entire warehouses shut down, he said.

Those issues will only compound the drug shortages Canada has been grappling with for years. On average, companies report roughly five new drug shortages per week, the pharmacists' association says.

In 2018 it commissioned a survey of more than 1,700 pharmacists across the country, which showed that close to 80 per cent felt drug shortages had increased in the past three to five years.

This report by The Canadian Press was first published April 1, 2020.

Laura Osman, The Canadian Press

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