Pharmacists in the provinces of Ontario and Quebec have been asked to fill only 30 days worth of prescriptions to ensure the supply of medications. (iStock)

Doctors warn of looming drug shortages

Doctors in the province of Ontario say COVID-19 cases are skyrocketing and that the province may again face “serious drug shortages.” Early in the pandemic there were concerns about getting enough supplies of active pharmaceutical ingredients from China and India. These two countries supply most of these  ingredients that are used in North America. 

By mid-June 2020, Ontario doctors and pharmacists were asked to provide patients with only one month’s worth or less of medication to make sure supplies remained adequate during the first wave of the pandemic. Residents of the province of Quebec too, are only allowed to buy up to 30 days worth of prescription drugs at a time.

Shortages exacerbated by the pandemic

In August, doctors and pharmacists across Canada wrote to the prime minister to highlight shortages of essential and critical medicines exacerbated by the pandemic. These included propofol, ketamine, succinylcholine, fentanyl, midazolam and others. These are drugs that are essential in treating patients with COVID-19  and they are also used in surgery, emergency departments and palliative care. There have also been shortages of some antibiotics. 

Drug shortages include those needed in operating rooms. (iStock)

‘Drug shortages can be catastrophic’

A white paper on the issue has been released by the Ontario Medical Association (OMA) which represents at least 43,000 doctors, medical students and retired physicians. It recommends that Canada increase domestic production of essential drugs and that all levels of government work to ensure there is a sufficient supply of essential medication for the duration of the pandemic. 

“Chronic drug shortages have worsened during the pandemic and may become even more serious if hospitals become overwhelmed with COVID cases in the coming weeks,” said Dr. Samantha Hill, president of the Ontario Medical Association. “Drug shortages can be catastrophic for patients, causing treatment delays, increased suffering, financial burden and an increased risk of overdose and underdose.”

Doctors seek to minimize drug waste. (iStock)

Doctors call for a centralized supply monitoring system

The association recommends changes to allow the safe return and distribution of unused medications, to minimize the waste of drugs and the development of a framework to guide the allocation of drugs. “Drug shortages seriously affect patient care and can force health-care providers to make very difficult choices,” said OMA CEO Allan O’Dette. 

The association calls for the development of a centralized drug supply monitoring system which includes reasons for and anticipated duration of shortages. It says the recommendations are based on lessons learned from the first wave of the pandemic which did not overwhelm Ontario hospitals. It notes that it is more important than ever to address drug shortages as projections suggest Ontario will see increased cases and hospitalizations in the coming weeks.

As of 2016, the government of Canada’s health department requires drug makers to report actual and anticipated drug shortages. They also must report discontinuations. 

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