Libby demands action on drug shortages



House of Commons

March 12, 2012

Ms. Libby Davies (Vancouver East, NDP)

Mr. Speaker, first of all, I would like to say that I will be sharing my time this evening with the hon. member for Beauharnois—Salaberry.

I would like to thank you, Mr. Speaker, for agreeing to my request to have an emergency debate on this very critical issue of drug shortages in Canada. I made the request on Friday and I am very glad that the House has an opportunity to discuss this very critical issue. Being in our ridings and our home communities over the weekend, I have no doubt that many members of Parliament probably heard from constituents how concerned they are about this escalating drug shortage in Canada.   

We know that this shortage has been ongoing for a period of time, but in the last month or so it has become something that is now approaching a critical nature because of the closure of the Sandoz plant. We are also aware that this shortage is projected to last 12 to 18 months. Across the country many regions have had to change their prescription strategies to use replacements, often without experience about how they work, and to limit elective surgeries. As we gather information across the country and from ongoing news reports, we know now that pretty well every province and region is affected.

We need to put on the record that this shortage is having the most serious impact on patients in intensive care units and those who are dying and in need of pain management. We know that hospitals in Quebec are cancelling elective surgery and that hospitals in Ottawa are saying that they will probably have to do so in the next few weeks if their drug supplies are further depleted. We also know that in Alberta, Manitoba and B.C., they are also suggesting that they will have to do the same if the situation continues.

Although I am not a health expert, certainly from all of the information that we have before us, we know that injectable opiates are the main method of pain control for surgery, post-operative care and any hospital admission. With the hospitals running low on these drugs, they are now being forced to cancel elective surgeries and to save the medications for severely ill patients and those who need serious pain management.

We know, for example, that for patients in Alberta who are undergoing chemotherapy they are now being asked to buy their own anti-nausea drugs because the hospitals can no longer provide extra supplies. These drugs are very expensive. They can cost up to $13 a pill and it is good to know that the Province of Alberta has said it would reimburse the cost, but still it puts patients at a great hardship and disadvantage.

Right across the country there are stakeholders, health care interests, who are speaking out and I would like to read into the record some of what is being said about this crisis. For example, Dr. Rick Chisholm, president of the Canadian Anesthesiologists’ Society, has been calling on the federal government to develop a national strategy to “anticipate, identify and manage shortages” of essential drugs.

We know that the Ontario Health Minister, Deb Matthews, has said that Ontario did not get any advance notice about the shortages. In fact, she pointed out that the provinces have no way of knowing when a supply is short because the federal government does not require drug companies to report gaps in supply. 

We know that the Alberta Health Minister, Mr. Horne, has said that “We’re not going to stand by and simply wait to hear from Sandoz”, the company that shut down, “or the federal government”. 

We hear from a specialist nurse manager in Vancouver who specializes in pain management, who says that she cannot understand how the federal government has allowed the supply of all injectable opiates to be threatened.

The Cancer Society has pointed out that Health Canada is the regulator of drugs. It approves and certifies drugs for sale and monitors safety and regulates the way drug companies operate. It also points out that other countries have taken much more action to protect patients, including mandatory reporting and inquiries to address the root causes. It calls for a plan that must focus on the needs of patients.

We also know that the Canadian Medical Association did a survey more than a year ago where 74% of doctors surveyed said that they had encountered shortages of generic drugs, most commonly antibiotics.

 We also know, and this is very concerning, that the Canadian Pain Society has reported that it is seeing an increase in people who are feeling suicidal because they are so worried about the lack of medication that they depend on every day. We are facing an incredibly serious situation.

There have been many reports over the years from the Canadian Pharmacists Association. The pharmacists have been sounding the alarm on this issue for a very long time and there have been media reports. Yet the response we have seem from the federal government has been, at best, completely inadequate and in fact really quite pathetic.

What has the federal government done? Well, it set up a voluntary reporting system. As we have heard from some of the provincial health ministers, setting up a voluntary system does nothing to require these companies to report information when they know they are going to have a shortage.

I think it is very interesting that in the United States, by contrast, in October 2011, President Obama issued an executive order directing the FDA to require drug manufacturers to provide adequate notice. In fact, there is currently legislation in the American Congress to require, not just ask, all companies to give six months’ advance notice of potential shortages, punishable by civil fines for non-compliance that could reach $1.8 million under the proposed bill.

We can see that this problem is very widespread. It does not just involve Canada, but other countries have taken much more serious note of what is happening and are being proactive in intervening and ensuring that patients are not suffering.

It is very sad and disturbing, unfortunately, to see that the federal government and Health Canada have not taken such action in Canada. Therefore, I think it is very important to have this debate to hear the perspectives of different parties on the nature of the crisis and what we believe should be done.

I would suggest that the first issue we need to focus on is the need for Health Canada and the federal government to become much more involved in this issue. A voluntary committee is just not going to cut it. We know that provincial health ministers are now having daily calls to try to sort out this mess and the very real threat they face in deciding what to do in their individual jurisdictions and with the hospitals that depend on these now unavailable drugs.

I think it is imperative that Health Canada and the federal government acknowledge that they have not been proactive on this issue. Calling for voluntary measures to set up a website has not done anything to mitigate the crisis now before us. They need to take much stronger action.