Drug shortage could create problems ramping up surgeries post-pandemic, experts say

A group of Alberta organizations wants support from the province to create a facility that would handle packaging vaccines and other medications to address drug shortages in Canada. 

The dearth has plagued the country for a decade and the COVID-19 pandemic has exacerbated the issues — like exhausting the supply of a drug used to ventilate patients or trouble procuring certain medications from overseas. 

Applied Pharmaceutical Innovation (API) has put together a coalition of companies to make a "fill finish" facility to complete the last steps of manufacturing vaccines and other drugs to boost medication security in Alberta. 

The group submitted a proposal under the province's call for applications earlier this year and is waiting to hear back about what funding or support from the government might be available. 

It's not just for COVID-19 vaccines. The group intends to have the proposed facility contribute to shoring up Canada's supply of other common drugs once the pandemic is over. 

"It's still a big inefficiency within our health-care system, not having a steady supply of some of these drugs," Andrew MacIsaac, the CEO of API, said.

Experts are warning there may be issues ramping up surgeries and health-care capacity again after the pandemic if these drug shortages continue. 

"It could end up being a challenge for the province as they try to move through what is essentially a year and a half of backlog of surgeries," MacIsaac said. 

Chronic issues with procurement continue

Propofol, a drug used when a patient is put on a ventilator, has been in higher demand during the pandemic. It's also often relied upon when putting someone under anesthetic for surgery. It is listed by Health Canada as a Tier 3 shortage — deemed to have the greatest potential impact on Canada's drug supply and health-care system.

"If there's shortages of propofol, hospitals delay surgeries or reschedule and find ways to move around it," MacIsaac said.

The supply chain issues that lead to these problems can't be solved by one facility, according to Lorian Hardcastle, an associate professor at the University of Calgary's Cummings School of Medicine. 

"Drug shortages have been a chronic problem in Canada for at least 10 to 15 years."

While there's typically many options of drugs to accomplish things like ventilating a patient, they can be more expensive and create more stress on the health-care system as workers have to constantly pivot, she says. 

As surgeries increase again in post-pandemic Alberta, Hardcastle says the province will be competing with the rest of the world for those drugs. 

"Different health systems around the world are putting orders in to get those drugs that are required to do surgeries."

Hardcastle says she doesn't expect drug shortages to lead to surgery cancellations, but it's a warning sign to governments across Canada that this long-standing issue needs a permanent fix. 

The UCP provincial government's election platform promised to reduce surgical wait times down to an average of four months by 2023, and reduce the list of those waiting longer than three months by 75 per cent. 

The proposals for domestic vaccine manufacturing are being reviewed by the government, which is expected to announce the next stage of the process near the end of April.