Understanding Drug Shortages in Canada

Written by: CDHF

Updated: January 29th, 2025

A drug shortage occurs when a drug manufacturer cannot supply enough of a medication to meet Canadian demand on time. Both drug shortages and product discontinuations remain significant challenges within Canada’s healthcare system. On average, there are 242 shortage reports and 34 discontinuation reports per month.

What Causes Drug Shortages?

A drug shortage can last for a short period or extend over a long time, impacting patients who may find their medications are back-ordered, out-of-stock, or discontinued altogether. Several complex and interconnected factors can contribute to drug shortages in Canada:

Manufacturing problems or delays
Difficulty obtaining raw materials or ingredients
Sudden increases in demand
Drug discontinuations
Natural disasters
Pandemics

Additionally, issues surrounding drug pricing, regulatory reviews, and provincial reimbursement processes can influence pharmaceutical supply.

The Impact of Drug Shortages on Canadians

For patients, a drug shortage can mean difficulty filling prescriptions or finding medications in local pharmacies. Health Canada recognizes that shortages not only affect patients and caregivers but also place considerable stress on healthcare providers and the broader healthcare system. Health products like drugs and medical devices are essential for maintaining and improving health, and shortages can have profound implications.

Addressing Drug Shortages: A Shared Responsibility

Tackling drug shortages requires a coordinated effort among various stakeholders:

Drug Manufacturers: Decide which drugs to produce, market, and sell.
Healthcare Providers: Make prescribing decisions in consultation with patients.
Provinces and Territories: Oversee reimbursement and healthcare delivery systems.
Federal Government: Ensures regulatory oversight and monitors shortages.

The Government of Canada, through Health Canada, plays an active role as a federal regulator. Its priorities include assessing drugs and health products for safety, efficacy, and quality, while also ensuring Canadians can access essential medicines when needed.

Key Federal Measures to Address Drug Shortages

In recent years, the Government of Canada has introduced initiatives to bolster the supply of health products:

Pediatric Drug Action Plan
Biomanufacturing and Life Sciences Strategy
National Strategy for Drugs for Rare Diseases
New regulatory tools to address shortages and protect the drug supply from foreign bulk importation programs

To further address these challenges, Health Canada has laid out its forward-looking plans:

Building Resilience: Health Canada’s plan to address health product shortages (2024-2028)
Annual Shortage Reviews:
- Drug Shortages in Canada: Fiscal Year 2023-2024 in Review
- Drug Shortages in Canada: Fiscal Year 2022-2023 in Review

What to Do if Your Medication Is in Shortage

A drug shortage (also referred to as a medication shortage) becomes apparent when you cannot fill your prescription due to back-orders or depleted stock. To help patients, manufacturers are required by law to report anticipated and actual drug shortages on the Drug Shortages Canada website. Both patients and healthcare providers can consult this site to check reported shortages or discontinuations.

Steps to Take If You Suspect a Shortage:

Consult with Your Pharmacist or Doctor: They can discuss alternative treatment options, such as:
- Switching to a different generic or brand version of the same medication
- Using a drug with the same active ingredient in a different strength or format (e.g., splitting higher-dose tablets)
- Substituting with a similar drug that has a different active ingredient
- Exploring other approaches to address your medical needs
Check for Reported Shortages: Visit Drug Shortages Canada to confirm if a shortage has been reported.
Contact Health Canada: If a shortage has not been listed, email Health Canada at Drug.shortages-Penurie.de.medicament@hc-sc.gc.ca.

The Case for an Essential Medicines List

In light of high-profile drug shortages and ongoing discussions surrounding a national pharmacare program, many experts advocate for establishing a Canadian Essential Medicines List. Such a list would include 200-500 critical medicines (e.g., prescription drugs, over-the-counter medications, and essential health products) chosen for their safety, effectiveness, and affordability. The government would commit to ensuring these essential drugs remain in consistent supply.

During the 2012 drug shortage crisis, the House of Commons Standing Committee on Health recommended adopting an Essential Medicines List to improve prescribing appropriateness and manage drug spending. While this recommendation has yet to be implemented, it remains a widely supported measure to improve access to critical medications.

Building a Resilient Drug Supply Chain

Ensuring an uninterrupted supply of medications requires a collaborative approach:

Establishing national and provincial stockpiles of critical medications
Expanding the number of approved manufacturers
Improving communication and coordination among:
- Drug manufacturers
- Raw material suppliers
- Pharmacists
- Distributors
- Public and private payers
- Provincial agencies

By strengthening partnerships across industry stakeholders and government bodies, Canada can build a more resilient and sustainable pharmaceutical supply chain to meet the healthcare needs of all Canadians.

How to Get Involved

Consultation by Health Canada until March 8 : https://www.canada.ca/en/health-canada/programs/consultation-proposed-amendments-regulations-health-product-shortages.html

Other Interesting Sources

Comparison between US and Canada : https://jamanetwork.com/journals/jama/fullarticle/2825535 (recently published by the University of Toronto according their mandate from Health Canada)