Health Canada working to mitigate breast cancer drug shortage
Health Canada says it is working with drug companies, provincial and territorial governments and health professionals to mitigate the national shortage of tamoxifen, a drug commonly prescribed to breast cancer patients.
The shortage has meant some pharmacies are limiting the amounts of the drug they sell and some patients are being told to cut their tablets in half to make their supply last longer. The oral drug, often prescribed to breast cancer patients after surgery to reduce risk of a recurrence, is taken daily, usually for between five and 10 years.
“This is a national shortage, and while the product remains available within the healthcare system, Health Canada is aware that supply levels are low,” said Anna Maddison, a spokesperson for Health Canada.
“The health and safety of Canadians is our top priority, and we recognize the significant impact that this shortage has on patients.”
When national shortages occur, Health Canada works with groups across the drug supply chain to determine details of the shortage, coordinate information sharing and try to find mitigation strategies, said Maddison.
That could include “regulatory measures” to speed up resupply, if possible.
“Health Canada considers factors such as the scope of the shortage, the availability of alternative supplies and whether the product is medically necessary, in determining the potential impact and any actions necessary to help mitigate the impact of these shortages on patients,” she said.
Tamoxifen is supplied in Canada by three pharmaceutical companies — Teva Canada Inc., Apotex Inc. and AstraZeneca Canada Inc. — and all are reporting shortages of the drug due to “manufacturing disruptions and increased demand,” according to Health Canada.
Tamoxifen is not the only widely used drug in short supply or unavailable. Other drug shortages include drugs prescribed for cancer and other conditions.
In a study published by the C.D. Howe Institute in 2018, authors Jessy Donelle, Jacalyn Duffin, Jon Pipitone and Brian White-Guay, found there had been around 1,000 drug shortages reported annually in Canada during a three-year period. Those shortages affected 1,250 products and appeared to be increasing.
Some studies have shown that drug shortages might lead to illness and even premature death, the authors wrote.
“Shortages provoke great anxiety among patients who cannot obtain trusted medications for chronic conditions. For pharmacists and the care team, shortages demand time-consuming and often frustrating searches for alternatives. For patients, they result in the stress and harm of delayed treatments and surgeries. For governments, they increase healthcare expenditures to acquire the scarce products or their replacements from other sources or innovator substitutes,” they wrote.
Among proposals for improving the situation, the authors suggested the creation of a nationally owned pharmaceutical manufacturing entity, noting that since 1960, the number of companies owned or based in Canada has declined sharply.
Health organizations fear the advent of U.S. states buying drugs in Canada — as some are proposing — could create a drug shortage crisis here.
The federal government says it is monitoring developments in the U.S. “to better understand the potential implications of the U.S. proposal,” said Maddison.
“The Government of Canada is committed to safeguarding access to prescription drugs for Canadians.”