Health Canada says special imports of ibuprofen from the United States are awaiting distribution, while imports of acetaminophen from Australia are imminent. The agency did not disclose how much was expected or how the supplies would be shared among hospitals, but promised “a fair distribution of the supply across Canada.” “Ibuprofen has been imported and distribution to hospitals is expected to begin soon,” Health Canada said Wednesday in an emailed statement. The emergency measures follow a months-long shortage of children’s pain and fever drugs that has led many parents and carers to clear bare shelves and exchange advice on drug monitoring. Health Canada attributed the problem to “unprecedented demand since the summer,” with supplies “limited” to stores and hospitals in various parts of the country. Observers point to a complex web of factors driving demand, limiting supply and complicating any attempt at a quick fix. A glance:
WHY IS THERE A SHORTAGE?
It all started with a spring shortage of a particular brand of acetaminophen, which in turn sparked a secondary push for alternative brands and products, including those containing ibuprofen, says drug policy expert Mina Tadrous, an assistant professor at the University of Toronto. Leslie Dan Faculty of Pharmacy. . It was followed by an unusual late-summer outbreak of respiratory syncytial virus, a common fall and winter illness in children known as RSV that continues to plague hospitals today. In addition, the drop has led to “huge numbers of patients” affected by influenza and COVID-19, says the emergency director for the pediatric emergency department at the Children’s Hospital at London Health Sciences Center in London, Ont. “This year is extremely difficult,” Dr Rod Lim said earlier this week. “We’re seeing viruses release at different times than traditionally.” Parents are understandably concerned, but media coverage may have led some to hoard bottles and exacerbate the problem, suggested Health Canada’s chief medical adviser, Dr. Supriya Sharma, during a media briefing on October 7. “We really want to make sure that people only buy medicine when they need it. I know there’s a tendency to make sure they have medicine there just in case. But that leads to some panic buying out there.”
WHY CAN’T DRUG MAKERS JUST DO MORE?
Industry group Food, Health & Consumer Products of Canada said pharmaceutical companies, including Tylenol maker Johnson & Johnson and Advil maker Haleon, have ramped up production to cope with the surge in demand. But this is unfolding in a very unusual year, adds the president of a group representing pharmaceutical distributors. Angelique Berg of the Canadian Association for Pharmacy Distribution Management notes that inventory typically rises steadily from May to August, filling the supply chain in preparation for cold and flu season demand. “However, what happened was that demand shifted so much earlier and grew so much more sharply that even trying to catch up is a maddening task for producers,” says Berg, noting that spring and summer inventory was very depleted. earlier than expected. “I think everyone in the supply chain was hoping that (demand) would go down. It hasn’t.” Tadrous says it’s not easy for a drugmaker to pivot with such swings in demand: “In most cases, it takes months to fix the supply chain.” Tadrous points to myriad factors that go into production, including raw material sourcing, factory schedules, labor issues, and the details of bottling, labeling and shipping. “These supply chains are global, there are drugs that are produced in one place and distributed all over the world. They have to label them and make boxes and probably some drugs flow from one factory to another to a third factory,” he says.
WHAT DOES HEALTH CANADA DO?
Health Canada says it is working closely with manufacturers and distributors of pediatric/infant and children’s acetaminophen and ibuprofen products to ensure more supply to community pharmacies and consumers. Any imports will be evaluated to ensure they are reliable, safe and effective, Sharma said, but noted that special labeling requirements are an extra step needed to ensure consumers understand how to use the product. In addition to shipments from the United States and Australia, Health Canada said it is considering more proposals to import foreign products and that any such products will include information in both official languages.
WHAT ELSE CAN BE DONE?
Medical historian Dr. Jacalyn Duffin says the uproar over children’s pain and fever drugs is just the latest controversy to highlight the long-standing vulnerabilities of Canada’s drug supply. Duffin, who tracks drug shortages on her website CanadaDrugShortage.com, analyzes a myriad of issues that contribute to shortages of all kinds of drugs far beyond acetaminophen and ibuprofen, but notes that many of the most meaningful fixes would require global partnership, including the industry’s largest drug makers. “The supply chain is very fragile. It shouldn’t be that fragile. We need to know where each drug is coming from. And we need to know which ones are vulnerable to supply chain demand problems,” says Duffin. “We have to grow up as a country and start paying attention to them and not try to think we can solve it within our borders because we don’t make the drugs here. Therefore, we need to engage in an international debate.” A stockpile of some drugs could help when unanticipated demand occurs, Tadrous suggests, but then we’ll have to decide what’s worth putting into that national supply. “We can’t stock everything. You also worry about wasting money buying all these drugs, and then they go out of supply, they expire.” Domestic production is another gap, he suggested. “You want to start making sure you’re incentivizing more production, local production, production that’s coming from multiple countries, not just one site, having a dynamic market there,” Tadrous says. — With files from Holly McKenzie-Sutter in Toronto. This report by The Canadian Press was first published on November 10, 2022.
