Hospitals are scrambling to implement contingency plans in the face of a cross-country shortage of injectable drugs, the latest crisis in a supply problem that many health-care practitioners say is becoming increasingly endemic.
Last weekend, a fire at Sandoz Canada's Boucherville, Que., plant temporarily halted production of about 90 per cent of injectable drugs used in Canada, squeezing the supply of vital anesthetics, painkillers and antibiotics and leaving hospitals and pharmacies fretting over how long their supplies would hold out.
At least two Quebec hospitals cancelled elective surgeries for several days this week, and B.C.'s Health Minister has warned that the province could face similar delays. Other hospitals are tracking their supplies closely, and many have agreed to share the drugs as needed until the shortage is resolved.
"In regards to medication issues, this is one of the most significant challenges we've faced in recent memory," said Michael Cohen, vice-president of clinical services at the Queensway Carleton Hospital in Ottawa. "The scope and potential impact are significant."
Mr. Cohen said the Queensway Carleton has an adequate stock of drugs for now, but is watching its supply level carefully and coordinating with other hospitals in the region.
The recent fire was only the latest obstacle for Sandoz, which had previously suspended or discontinued production of some drugs over concerns raised by the U.S. Food and Drug Administration about contamination in its factory.
But health-care practitioners argue that periodic shortages of everything from chemotherapy medications to generic painkillers are becoming the new normal. They say stronger government regulation is needed to ensure these shortages don't become health crises jeopardizing patient care.
Asked to explain why federal rules did not prevent the shortages, Prime Minister Stephen Harper laid the blame at the feet of the provinces.
"Certain provinces have undertaken to sole-source certain critical medications," Mr. Harper said during the daily Question Period in Parliament. "Health Canada is working on a range of options and solutions, including the fast-tracking of approvals for that particular problem, and obviously we work with and encourage provinces to find multiple sources for vital medication."
But the federal government is responsible for making the provinces aware of any production problems and slowdowns, Ontario Health Minister Deb Matthews told reporters on Thursday. The problem, she said, is the voluntary system for companies announcing problems, one she said the Harper government implemented.
"That just isn't good enough," she said, adding that she only found out about the problems at the Quebec plant on Feb. 28. The company knew about this well before then, she said.
A spokesman for federal Health Minister Leona Aglukkaq later said that while the government still believes a voluntary reporting system is the quickest way to get information to patients and doctors, it is open to other options.
"We're really concerned about how Sandoz has handled this situation, and if a voluntary approach isn't what ultimately gets this information into the hands that need it, we are open to other solutions, including regulation," Steve Outhouse said.
A spokesman for Sandoz wrote in an e-mail Thursday that the company has been working to keep health-care practitioners informed through a protected section of its website and that it plans to partially resume production next week.
Deborah Dunn-Roy, of Health Shared Services BC, said health authorities in the province were first notified of the shortage on Feb. 17 and have been redistributing drugs internally ever since. In rural areas, she said, there have been a few situations where limited stocks of certain drugs have been wiped out and replacements have been flown in either from Sandoz or from elsewhere in the province.
Alberta Health Services is also shipping drugs within the province to maintain inventories, said medical director for pharmacy services James Silvius. "We have had isolated shortages," Dr. Silvius said. "But nothing on this scale."
With reports from Gloria Galloway in Ottawa, Karen Howlett in Toronto and The Canadian Press