Cancer Drug Shortages in Canada a Cause for Serious Concern, Doctors Say

August 6, 2019 Updated: August 6, 2019

Cancer professionals in Canada are raising the alarm on national shortages of three important drugs that have led to hospital staff struggling to find alternatives.

The drugs, which are considered to be a crucial part of Canadian cancer treatment options, are vinorelbine, leucovorin, and etoposide, and are all administered by injection into a patient’s veins.

Vinorelbine is used to treat non-small cell lung cancer and breast cancer, while etoposide is used to treat lung cancer and testicular cancer. Leucovorin’s function is to diminish the potentially dangerous side effects of other drugs used during chemotherapy.

The three are listed on Health Canada’s official drug shortage website as drugs currently experiencing nationwide shortages. Vinorelbine is reportedly the hardest hit by the shortage, as there is no projected date so far on how soon it will start to be available again. Pfizer Canada and Teva Canada Ltd., two pharmaceutical giants in Canada, have already discontinued production of the drug.

Since the three drugs are no longer patented in Canada, they don’t hold the same marketable potential as other patented drugs, and it’s harder for companies to invest in producing them when there won’t be as much profit.

To deal with the national shortage, oncologists in Canada have been using similar drugs with the same effect as substitutes, but it’s unclear how long this tactic will be able to go on.

“It will affect people,” Montreal oncologist Gerald Batist warned in an interview with the Montreal Gazette. “I don’t know what’s happening in the rest of the province, but everyone is scrambling to try and do their best.

“It’s like a bunch of divers all breathing off of one [oxygen] tank. They have to share. It’s crazy.”

On the Drug Shortages Canada page, Health Canada called drug shortages a “complex global problem.”

“Health Canada recognizes the negative impact of drug shortages on patients, health care professionals, and the health care system, and works together with stakeholders to build a more open and secure drug supply system,” they wrote on the site’s “about” section. “Everyone has a role to play in addressing drug shortages.”

‘Pharmacist Stress’

The announcement about these national shortages follows the results of a recent survey released by the Canadian Pharmacists Association. During their research, the CPhA surveyed 1,743 pharmacists currently practicing medicine across Canada, and asked them about the number of drug shortages and recalls that they’ve observed over their career.

The results were significant. About 95 percent of responding pharmacists reported that, based on their experience, they believe drug shortages have increased over the past 3-5 years, with 79 percent saying that shortages “greatly increased” and 16 percent saying that they “somewhat increased.” In addition, about 67 percent of the respondents said they have to deal with drug shortages daily, or even multiple times a day.

The respondents also estimated that the time they take to manage the shortages can occupy up to one-fifth of their shift—beating out the time they spend on immunizations, business management, and staff management.

Seventy-five percent of the participating pharmacists also responded “never” or “infrequently” when asked how often they receive advance notice from providers about shortages in the drugs they use. At the end of the survey, an overwhelming 96 percent said that they experience “pharmacist stress” as a direct result of drug shortages.

CPhA said in their post-survey statement that they are “calling on the federal government to develop an action plan to address the issue of drug shortages.” This can include “further research into the root causes of shortages, convening an international taskforce to identify and implement solutions, and better support for frontline health care providers,” the statement said.

“In addition, we call upon the Government of Canada to clearly articulate its position regarding the exportation of Canadian medications to other countries, and put measures in place to protect our drug supply from the impact of U.S importation legislation.”

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