There is a concern that more prescription drug shortages might occur if a second wave of the COVID-19 pandemic happens and if American hospitals and health agencies are allowed to import more medications from Canada.
In Sudbury, Health Sciences North said it is aware of the situation, but so far, drug shortages have not been an issue.
"HSN monitors this closely, and at this point, we have been able to manage supplies without impact on patient care," said the reply from the hospital.
The issue was more urgent back in March when the number of coronavirus cases was beginning to spike in most parts of Canada Because of the concern raised by Health Canada, Patty Hadju, the federal Minister of Health signed an interim order (IO) "that allows certain drugs that may not fully meet regulatory requirements to be imported and sold in Canada."
Christina Adams, the chief pharmacy officer with the Canadian Society of Hospital Pharmacists (CSHP) said this meant that Canada was able to import medications from the U.K. and Europe, specifically those drugs that were on the "Tier-3" list.
"Tier-3 status are essentially medications that are either short or anticipated to be short in Canada that have a significant clinical impact on the health of Canadians if those medications are not available," Adams explained.
Health Canada has a list of 32 Tier-3 drugs that are in short supply. Of that number, 24 are drugs used to treat COVID-19 and related ailments. These drugs include pain medications, sedatives and paralytic agents for patients being put on respiratory ventilators or undergoing surgery.
Health Canada, on its website, also stated that there are several reasons for the shortages; among them are supply issues in obtaining raw materials from overseas sources, manufacturing issues with equipment problems, recall problems and contract issues such as sole sourcing for numerous drugs.
Health Canada said it also recognizes the negative impact of drug shortages on patients, health-care professionals and the health-care system, and is working with stakeholders throughout the supply chain to better prevent, mitigate and communicate shortages.
Adams said health care providers were indeed worried earlier this year.
"At the beginning of this pandemic when we weren't sure what the numbers would be for Canada, there was definitely a significant concern of not having enough medications to meet the needs of Canadians if we were to have the type of surge that was seen in New York City,” she said.
As things turned out, Canada got through the worst of it.
"We had enough for the Canadian drug supply at the time,” Adams said. “We didn't have anything short. We had a good supply. What the COVID-19 pandemic did was tell us we needed a lot of more and that's where it was an anticipated shortage because if we were going to have large numbers of patients with COVID-19 we might run out of medications because it was more than what our usual demand is.”
Holding our own
"At the moment we are holding our own. Our numbers are sufficiently low and they have remained that way more or less in the majority of Canada to ensure we have enough medications to meet the needs of our patients. By being able to flatten the curve and bring down the numbers even more, we gave the manufacturers time to ramp up production."
Adams said she is still concerned by talk coming from south of the border to have American hospitals and health agencies try to tap into Canada's drug supply. It is something she strongly opposes.
Earlier this year, Adams spoke to the Connecticut General Assembly to reveal that the CSHP is against the idea of the U.S. importing more pharmaceuticals from Canada, an idea that was being discussed by legislators in the U.S. Adams testified that Canada does not have the capacity to become a drug supplier for the United States.
"Our nation of 38 million people does not have the pharmaceutical supply for your 329 million citizens. We’re already experiencing drug shortages. Currently, there are as many as 2,000 medications in short supply," Adams said.
In the meantime, Adams said there are steps that can be taken to avoid future shortages, such as allowing Canadian pharmaceutical companies to produce more.
"Health Canada has the ability to do that up to point,” she said. “It is a very delicate balance for them I'm sure between allowing a private company to operate privately but also ensuring that Health Canada is looking out for the needs of Canadians in ensuring we have enough medications for everyone.”
Adams added that Canadian drug manufacturers should be encouraged to produce a wider variety of pharmaceuticals on their own and not be left to rely on international drug firms.
Expecting second wave
"We are expecting a second wave, and we have been planning for that with the amount of medications we are trying to secure,” she said.
“If we have a COVID-19 surge in the fall we should be fine. The only time I think we would not be is if there was a disruption in the supply chain that was outside of Canada's borders that we didn't have any ability to influence."
She said this could be from trade restrictions, a shortage of raw materials from international drug supply companies, or unusually high demand for medications from other countries, such as the United States.
"I will say a shortage is unlikely for Canada, but I won't say it won't happen, because you never know."