Longstanding shortage of ‘critical care’ drugs ‘exacerbated’ by COVID-19 pandemic, medical experts say
Nearly two-thirds of the drugs on Health Canada’s Tier 3 Shortage List — which face shortages and lack ‘suitable alternatives’ — are ‘essential’ to treating COVID-19 and experts warn these shortages “imperil the lives of patients seeking care all over the country.”
The Critical Drugs Coalition, an organization of doctors and pharmacists, warned in an open letter to Canada’s Health Minister, 15 out of 24 drugs on Canada’s “Tier 3 Drug Shortage List” are “essential” to treating COVID-19 patients.
The group says Canada needs a strategy to boost their supply.
“These drugs are often used simultaneously in ORs, ERs and palliative care wards, as well as ICUs,” the letter states. “And while our ICUs are thankfully seeing fewer COVID-19 patients, the pandemic has been placing a heavy burden on their drug supply, where patients often require weeks’ worth of treatment on ventilators.”
“We’re seeing shortages of drugs like Ketamine, propofol, Fentanyl, and when you’re short those sedatives, it’s all patients that are suffering,” CDC co-founder Dr. Saad Ahmed told PressProgress. “Of the 19 drugs essential for treating COVID, there are 5 or 6 drugs we use for ventilated patients, but there’s a whole other set of drugs that we use for COVID-19 as well”
Other drugs on the list include Azithromycin, Ceftriaxone, Dexamethasone, Lorazepam and Midazolam.
Dr. Ahmed said Canada needs to consider increasing its drug-producing capacity to address the risk of shortages.
“What needs to be thought about is domestic production. Based on what our group has understood, we’ve lost a lot of domestic production capacity in the last 20 years,” Dr. Ahmed said. “We used to have a really robust sector for drug production, but we lost it to low cost offshore manufacturing.”
The letter’s signatories include the Canadian Association of Emergency Physicians, Canadian Doctors for Medicare, Canadian Federation of Medical Students, Ontario Medical Association and the Canadian Medical Association.
CMA spokesperson Elissa Freeman told PressProgress that “drug shortages have been an ongoing issue since at least 2010 and COVID-19 has exacerbated some shortages” and noted the CMA’s support for its recommendations, which include:
- A pan-Canadian Critical Medications List which the government commits to ensure are always in stock
- A publicly owned generic, critical drugs manufacturer, or public support for spare capacity by Canadian-based and controlled drug manufacturers
- Greater transparency and communications from governments around the supply of critical medicines
“The CMA supports the three recommendations in the letter, and in the immediate term a key action is vigilance to watch for signals of emerging shortages and to take measures to mitigate them,” Freeman said.