Protect Canadians from Drug Shortages

The following was published as a Letter to the Editor, in the Kingston Whig Standard, January 14, 2012

Kudos to the Whig-Standard for its front-page story on Jan. 5 (“Shortage of drugs ‘huge problem’ “). The current shortage has affected more people — from children to seniors — involved more drugs, especially generics, and lasted longer than past shortages, such as the one in 2004.

Without warning, you can be forced to switch to a substitute drug that does not work as well, or costs more. Some patients may be confused when drugs are changed, especially those with complicated cases. Others must simply make do without a drug for weeks at a time. Pharmacists have to find time in their busy schedules to track down supplies of replacement drugs.

Canadians have long recognized that health care is a legitimate area for government intervention. We value the health of our families too much to let our health-care system be subject to the vagaries of the free market. Because the federal government has responsibility for drugs, this is clearly an appropriate issue for Parliament to address but the Health Committee of the House of Commons has been unwilling to study it.

For that reason, three Liberal MPs — health critic Hedy Fry, industry critic Geoff Regan and I, in my role as science and technology critic — organized a roundtable in Ottawa last November, bringing together experts in health care, drug manufacturing and drug distribution to ask and answer questions.

What we learned, as the Whig article brought out, is that this is a worldwide problem without easy solutions. We do know that profits are low for generic drugs and that large purchasers such as the U.S. Medicare and Medicaid programs have been using their buying power to force prices down, while demand for drugs has been increasing in the developing countries.

Drug manufacturers around the world may be inclined to risk shortages and supply-chain disruptions, rather than make the investments needed to ensure steady supply of a product that may not contribute that much to their profits. Doctors, who do not have time to redesign treatments around the doubtful availability of certain generic drugs, often end up prescribing the more expensive brand-name drugs, driving up costs for patients, for government and for private supplemental insurers. This would decrease demand for generics and, in the long run, make the shortage of generic drugs a self-fulfilling prophecy.

Problems with the quality of manufacturing operations overseas have caused the U.S. Food and Drug Administration to tighten regulations and standards. That has meant costly delays for Canadian manufacturers and suppliers, who are subject to those regulations and also depend on imported raw materials. We know, for example, that injectable generic drugs, requiring special sterile manufacturing environments, have been especially affected by shortages.

Canadians — whether they suffer from attention-deficit hyperactivity disorder or cancer or simply need an antibiotic for a temporary infection — need to be protected from the threat of shortages. The federal government should take the lead in protecting its own people. It needs to be informed and it needs to cooperate internationally to manage this problem.

The drug industry in Canada has set up two websites to give health-care providers information on shortages. From her responses during Question Period in the House of Commons, it seems that our health minister is content that this action is sufficient, even though her ministry is neither funding the operations nor monitoring the accuracy of these websites.

In December 2010, a report from the Canadian Pharmacists Association noted that the U.S. government runs a website on drug shortages, and said this could be a model for Canada. The U.S. requires manufacturers to notify the government of shortages, and even potential shortages. The federal government should fund the operation of the database that gives up-to-date information on the shortages to doctors, pharmacists and patients. Parliament should work to understand the root causes of the problem, so that our government can devise policies to protect Canadians, and work with governments around the world to deal with the drug shortages.

Canadians care about the health of our families and communities. Can’t the majority government care enough to seriously study what has been identified as a “huge problem?”

Ted Hsu, MP

Kingston and the Islands

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