Drug shortages in health care institutions: perspectives in early 2014.

The year 2012 was perceived by many stakeholders as the worst ever with respect to drug shortages in Canada. Following receipt of a warning letter 1 from the US Food and Drug Administration in November 2011, Novartis International AG, on behalf of its Canadian operations at Sandoz Canada, issued a customer letter 2 in mid-February 2012 indicating that the company's production capacity would be significantly reduced for some time, that manufacturing would be suspended for many products, and that many other products would be available only in limited quantities through a national allocation process. Hospital pharmacists were active during the crisis in attempting to limit the impact of the resulting drug shortages. As a result of this crisis, unprecedented mobilization of stakeholders was observed throughout the country, and purchasing agents and professional organizations collaborated to form task forces at both the national and the provincial level. In addition, 2 bodies published key reports: in April 2012, the Ordre des pharmaciens du Québec (Quebec Society of Pharmacists) published a set of recommendations on interruptions in the drug supply, 3 and in June 2012, the House of Commons Standing Committee on Health published its own report on the Canadian drug supply. 4 Nearly 2 years ago, in February 2011, the Pharmacy Practice Research Unit of the Centre hospitalier universitaire Sainte-Justine launched a pair of open-access websites that present the current status of drug shortages in Canada (see www.fridaypm.ca [English] and www.vendredipm.ca [French]). The websites are updated daily by the drug manufacturers that are under contract to SigmaSanté (the group purchasing agent for hospitals in the Montréal and Laval areas and the Eastern Townships of Quebec), as dictated by a specific clause in the group purchasing agreement. In addition, the website is updated weekly by a major Canadian wholesaler (McKesson Canada) and on the basis of voluntary reporting by hospital pharmacists. Our research unit has been gathering data on drug short-total of 1081 drug shortages were reported over this 12-month period, which represents a 152% increase from the 429 drug shortages reported for a similar 12-month period in 5 The average duration of drug shortages has also increased considerably, with a mean (± standard deviation) of 141 ± 116 days (range 1–775 days) over the 12-month period from 6 In the most recent period of analysis (2011–2012), parenteral formulations represented 33% of the total number of drug shortages and 37% of the total …