A pharmacist in a cancer treatment centre reports that his hospital’s stock of cancer chemotherapy drug, paclitaxel, produced by the Canadian firm Biolyse, has run out. Soon an order will be placed with the American firm, Hospira.
The Hospira price for a treatment is $4000 — whereas the Biolyse price is $50.
The increased, unexpected, annual cost to his institution will be over $2M.
Health Canada inspectors revoked the licence of Biolyse because of publicly unspecified safety violations, and it had to stop production.
The pharmacist asks the following questions, which we cannot answer:
1. If safety had really been violated, why were pharmacies allowed to use up the remaining stock presumably made under the same “unacceptable” conditions?
2. Why is the American firm’s price for this drug 80 [EIGHTY!] times that of the Canadian company?
3. What are the real costs of manufacturing this drug?
pharmacies. Sometimes it is possible to get a replacement drug that way
depending on what the drug is.
The Centre for Addiction and Mental Health in Toronto as well as other hospitals are encountering extreme shortages of two very important and potent injectable pharmaceutical products. The product is Haloperidol LA 50 and 100 mg/ml intramuscular injection used as an antipsychotic agent. Possible availability for the latter is sometime in December; the former has no expected delivery date. In addition, the anxiety reducing Lorazepam 4 mg/ml, 1 ml vials is unavailable until sometime in December as well. Pharmacist-led discussions and communication is occurring with clinicians to determine best possible alternatives for patients, including those that have been stabilized on the long acting antipsychotic, Haloperidol.
Wayne Marigold, Director, Pharmaceutical Services
Centre for Addiction and Mental Health (CAMH)
An Ontario GP reports
Garamycin (otic and ophthalmic) and topical trentinoin are no longer available.
A 63 year old man wrote in late June and again in mid-August 2013:
Proctosedyl suppository (cinchoncaine and hydrocortisone) is not available in my Ontario city, and the manufacturer claims to have been having trouble making it. My pharmacist has been unable to find it or any substitute. He said that they hoped to have supply again in the first or second week of July. In another province where we went on holiday the local pharmacy did not have it, but had a different version as a substitute (proctol).
When I got home, my pharmacy and all the other ones in its chain in my city had neither proctosedyl nor proctol. I tried another chain. They did not have it. In mid-August, an independent pharmacy had only one small box of proctosedyl left and could not get any more, but was able to order in proctol.
The pharmacists called their suppliers — one had proctor the other did not. Therefore I wonder what is going on at the level of the distribution network.
This has been going on for two months (August 18).
A neurologist from Calgary reports that on 30 April 2013 Hoffman-LaRoche announced a shortage of tPA, an injectable drug used to treat acute stroke by breaking down clots. It is an old reliable drug first approved for use by US FDA in 1996.
Neurologists were given just one week’s notice and told that they can expect the shortage to last two weeks.
An alternative drug is available but it is not yet approved for use in Canada, although it may eventually prove to be superior to tPA. Neurologists are advised to obtain consent from their patients prior to using the unapproved treatment.
Since early January 2013 Canadians with epilepsy have been having difficulty filling their prescriptions for clobazam.
Epilepsy Ontario e-News has been tracking the problem and offering advice.
- Medication Alert: Some forms of clobazam are on back-order (January 4, 2013)
- Unable to get clobazam? Work with your doctor, pharmacist (January 11, 2013)
- National action plan could curb impact of drug shortages (January 18, 2013)
- Alternative drug therapy, close physician contact recommended during clobazam shortage (January 25, 2013)
- Client-pharmacist relationship crucial for those with complex disorders during clobazam shortage (February 1, 2013)
Sarah Begin – has also written about her experience with this shortage on her blog:
My Own Personal Experience With Canadian Drug Shortages - January 14, 2013
Your faithful webmaster has just been told that acebutolol–a generic, beta-blocker that she has taken for more than 12 years to control blood pressure–is now in short supply. Yes! it’s same the little pill you see above in the banner of this website.
Ironically, I leave tomorrow for a conference at Emory University in Atlanta — on the drug shortage problem.
The drug is said to be on back order. Nevertheless it does not appear on lists at any of the sites dedicated to tracking the shortages.
Instead of being able to fill the 3-month prescription, the pharmacist provided medication for 10 days, but charged the full amount and owes me the rest. He also promised to “phone around” to try find more somewhere in the city.
Neither he nor I have time for this fiddling– but there’s more (I know it–does everyone else?): suddenly stopping a beta-blocker can lead to angina, irregular heart rate, and heart attacks.
I’ll update this post when I have more information … if I am still here.
22 June 2012
While I was in Atlanta, my pharmacist found the remaining 80 days worth of pills. I notice that the manufacturer has changed. I am grateful. Looks like I will live to keep running this website.
The conference was interesting. Watch for a Consensus report on the Statements page.
25 September 2012
Well, it happened again. I renewed my BP meds again in mid-September 2012, and was told to come for pick up in two days. But when I got there, once again the pharmacist could give me only 10 days worth — and he owes me another 90 days. Three days later, I got a call that the remainder was in stock.
However, this raises a new question–not life threatening, but irritating.
I am on two prescription medications — each prescribed for three months–repeat times three ( a year’s worth). Normally, I would go to the pharmacy four times over the year.
Instead the two drugs are now out of synchrony owing to the shortage. I go twice for each renewal–that is SIXTEEN visits to the pharmacy every year instead of four. Maybe pharmacy owners actually like this arrangement — more visits=more sales of other stuff. I can’t believe that they do–but I wonder: Is anyone tracking the effect on sales? AND — who has time for this?