The generic drug shortage that has been plaguing patients and health-care providers since 2010 simmers on. This week, without warning, Ritalin is in short supply in Quebec. Last month it was a national shortage of not one, but two heart medications.
The mysterious drug shortage is now raging in more than 39 developed and emerging countries. Children in Malawi cannot get malaria drugs; people in India scramble to find treatment for tuberculosis. In China, it is therapy for thyroid disease. And everywhere, cancer medications suddenly vanish without warning.
Almost all of the drugs in short supply are generics, older, and less expensive because their patents have expired.
No one is measuring the extent of these shortages in Canada. No legislation has been passed to mandate notification. No leaders are trying to uncover its international and economic causes. We cannot pretend to address the problem without this information.
The Canadian government website devoted to the issue is left to the voluntary initiative of industry. The Multistakeholder Steering Committee, announced with much fanfare, released a so-called “toolkit” that clearly does not work, and as far as anyone can tell, the committee has not met since.
In short, the government of Canada is trying its best to ignore the drug shortage problem. When pressed, it blames the provinces.
This most-recent shortage draws attention to the ludicrious vote that took place in the House of Commons on Feb. 12. Dr. Djaouida Sellah, a physician and NDP MP (Saint-Bruno and Saint-Hilaire) introduced a private member’s bill C-523 to make shortage reporting mandatory. She has been shepherding it through the House for more than a year. Every Conservative member voted against it; every member of the Opposition including NDPs, Liberals, Independents, Bloc Québécois, and Greens voted in favour.
The vote is not only one more example of the scornful attitude to private member’s bills in general and the hopelessly partisan nature of the current government, it is a flagrant demonstration of governmental hypocrisy. Why? Because in March, 2012, in the midst of the media hysteria over the shortages produced by the Boucherville Sandoz slowdown, the House of Commons voted unanimously in favour of a motion (not a Bill) of NDP Libby Davies with exactly the same intent. That vote included all members of the Harper government.
We cannot rely on the pharmaceutical industry to solve this problem. It is, and has always been, devoted to making money, and it contends that there is already too much government interference.
Nor can we rely on our U.S. neighbours to solve it. The character of shortages in the United States differs from those in Canada. There it affects mostly sterile injectable drugs; here it also involves pills affecting a wide array of conditions.
Nevertheless, the U.S. government has been making more attempts to address the problem through notification and measuring. In October, 2011, President Obama issued an executive order to make the reporting of upcoming shortages mandatory, something the Harper government rejected yet again on Feb. 12. In that same month, the U.S. Food and Drug Administration filed its first mandated annual report on the state of the drug shortage crisis, while the U.S. Government Accountability Office has already tabled its own report on the reliability of these figures: new shortages may have declined, but when combined with persistent chronic shortages, they continue to rise. At least the Americans are demanding information and tracking the extent.
We know Canada has a problem, but we need to know more about it. When voluntary reporting does not work, the government has to make it mandatory, with appropriate penalties for non-compliance. If the government believes that the problem goes far beyond our borders, then Health Canada and Industry Canada should be working with their counterparts in the World Health Organization and the Organization for Economic Co-operation and Development to develop better data.
Jacalyn Duffin is a hematologist and historian who holds the Hannah Chair of the History of Medicine at Queen’s University. She also oversees canadadrugshortage.com