COVID-19 has certainly established a new normal. The ORA committee members have worked very hard to maintain the collaborative and constructive working relationships with Health Canada, Ministry of Health and Long Term Care, Ontario Medical Association, Patient Organizations, Canadian Life and Health Insurance Association and the Pharmaceutical Industry to keep the arthritis agenda moving forward.
I will devote this section to the Drug Shortage issue. While we have some 13,000 DINs for human use, there are probably 2,000 listed as “in short supply.” Pharmacists report that they are spending 20 – 25% of their time on drug shortages. The Multi-Stakeholder Steering Committee on Drug Shortages has representatives from a number of Health Canada departments, pharmaceutical manufacturers, suppliers, distributors, hospital and community pharmacists associations, provincial government drug programs, medical association and patient groups. The MSSC-DS has 3 Tier Assignment Committees to mitigate drug shortages: Tier 1 dealing with potential drug shortages; Tier 2 addressing drug shortages where there are potential alternatives; and Tier 3 working to mitigate drug shortages where there are no alternatives or possible alternative that would be difficult to obtain.
Hydroxychloroquine (HCQ) highlighted the serious issue of drug shortages as a result of COVID-19. The ORA played a major role in resolving the HCQ issue which was impacting patients with RA and Lupus. The ORA also presented the MSSC-DS with a list of other potential COVID-19 drugs that could cause shortages for the arthritis community: Actemra (Tocilizumab), Olumiant (Baricitnib), Kevzara (Sarilumab), Otezla (Apremilast), Kineret (Anakinra), and Dexamethasone. Both Actemra and Dexamethasone have been put on Tier 3 Assignment Committee.
Our goal is to keep potential arthritis drug shortages on the MSSC-DS agenda so we can avoid another HCQ episode.
Once regular surgeries resume we will no doubt see a spike in drug shortages. An additional problem as cited by a number of organizations is the guideline changes proposed by the PMPRB. As a result of the impending changes, there has been a significant drop in Canadian clinical trials and a reduction in new drug launches. Another potential issue is the US importation of Canadian drugs in an effort to reduce US drug costs. Four states are pushing hard: Colorado, New Hampshire, Florida and Vermont. Of note: Florida alone prescribes more drugs in one year than all of Canada. And now we see a spike in counterfeit medications.
Drug shortages are going to get worse – be assured that the ORA will continue to do everything it can to address these issues and ensure that people living with arthritis have access to the appropriate medication and service.