Drug shortage registry under discussion.

ciation is negotiating with drug manufacturers, hospital pharmacists and the Canadian Medical Association to create a national reporting system that would track drug shortages. “We still have a long way to go, but the discussions have started,” says Jeff Morrison, director of government relations and public affairs for the Canadian Pharmacists Association. Recent shortages of cancer drugs such as carboplatin, cytarabine, dacarbazine and vinorelbine, as well as periodic shortages of drugs ranging from some common antibiotics to anesthetics and antinausea medications have prompted physicians, pharmacists and other health care professionals to call for a national registry or portal modelled on one hosted by the American Society of Health System Pharmacists. In the United States, a physician or pharmacist encountering a drug shortage can inform the American Society of Health System Pharmacists, which then contacts manufacturers to confirm the shortage and obtain an estimated date when the drug might be available again. “It works great — it’s highly valued by both doctors and pharmacists in the States, and we have nothing like it in Canada,” says Morrison. “That’s what we’re trying to create.” A central registry that lists available alternatives to drugs in short supply would also save pharmacists and health care professionals time, says Myrella Roy, executive director of the Canadian Society of Hospital Pharmacists. The pharmacists and interested stakeholders, who will meet again in June, have spoken to Health Minister Leona Aglukkaq and secured her support, he says. But they have not yet determined a funding source for the registry. “Minister Aglukkaq recently tasked Health Canada with exploring options for improved management of drug shortages, and has written to industry to ensure a collaborative approach on this important issue,” Health Canada writes in an email. Currently, although manufacturers may contact Health Canada about shortages, they are not required to do so — something some physicians feel needs to change. Advance warning of pending shortages of carboplatin would have helped the Juravinski Cancer Centre in Hamilton, Ontario, which in May found itself without any carboplatin to treat patients with breast and lung cancer, says Dr. Peter Ellis, an oncologist at the centre. “We got three days’ notice that there was no drug supply,” Ellis says. “We were told there was a manufacturing issue and there wasn’t any additional information forthcoming. There are varying potential explanations for that, but one would have to assume the manufacturer had more warning of this than we did.” Although Ellis’ patients had their treatments delayed or modified for only about a week, he is worried that if these shortages persist they could affect the quality of patient care. Some form of federal government News CMAJ