Drug Shortages

Drug shortage may affect pet care too.

As several human hospitals delay elective surgeries because of serious drug shortages, Canada’s veterinarians are being warned to find alternatives to the scarce medications. Some will not be available at all for animal use until 2013, we are told.

Drug shortages have become a growing problem in recent years. It seems we just squeak through one crisis and another hits. The latest headlines have revolved around medications manufactured in Quebec by Sandoz Canada. The company was forced to halt or slow production of many of its drugs due to regulators’ demands for improved manufacturing processes. The situation was made worse by a fire at the Sandoz plant recently.

Amid much hair-pulling and finger-pointing, the only constant seems to be confusion. The factors causing these shortages are many — from government-imposed ceilings on prices and, therefore, reduced incentives to manufacture generic drugs to “arbitraging”, which basically means buying a medication cheaply in one market and selling it elsewhere for a higher profit. I wonder how much Canadian online pharmacies contribute to shortages by selling our cheaper generic drugs to Americans. One of the biggest culprits appears to be problems with manufacturing processes, leading to plant shut-downs or slow-downs.

So what drugs am I concerned about? Despite recent bulletins from various Canadian veterinary associations, I don’t know for certain and that’s a huge part of the problem – misinformation and confusion are leading to panic. To avoid hording of the affected drugs, pharmacies and hospitals are receiving controlled amounts based on previous usage. That’s where the warnings to veterinarians come in. Our patients won’t be getting any of certain drugs at all until authorities are sure human needs are met.

That list of medications includes various pain medications such as morphine, fentanyl and hydromorphone which we administer daily. Oddly, there are a number of Sandoz products including injectable antinausea drugs that weren’t included in the warning to vets – a cause for celebration or just more hair-pulling?

Confusion also inevitably arises over whether another manufacturer’s product is available as a substitute. Staff in human hospitals can spend hours every day just tracking down alternatives for unavailable drugs and veterinary clinics will be doing a lot more of this in the coming year. A number of websites have sprung up, listing drugs that are in short supply, along with anticipated dates for return to the shelves. The most up-to-date of these appears to be Friday PM.

Fortunately, veterinarians have some medications available to us as substitutes that are strictly manufactured for animal use. At least we did the last time I looked.

Canada Drug Shortage — an excellent overview of the problem in human medicine
Health Canada’s Drug Product Database – Look up alternative manufacturers of medications
Canadian Agency for Drugs and Technology in Health – Another in-depth look at the topic in human medicine.

Here is a link to a recent CBC article on the shortage… CBC News. Please note that we scooped ’em by about a week!

Dr. Fiona Gilchrist
Hillcrest Animal Hospital – March 2012