Navigating Drug Shortages
The information in this post is accurate to Canada as of September 9, 2019. The situation may have changed by the time this article is published. To check drug shortage situations in Canada, you can use Drug Shortages Canada. To check shortage information in the United States, the FDA publicizes this information.
Drug shortages can be not just frustrating, but extremely problematic for patients. I know drug manufacturing and the whole supply chain is still a business, but it is one with incredibly high stakes that lead to a lot of uncertainty for the people who depend on those drugs to stay healthy, safe, and/or comfortable.
Experiencing a drug shortage firsthand
When I submitted my refill request for Qvar and two other long-term medications on Friday, I—of course—figured I’d go to the pharmacy in a day or two and pick up my medications as usual. That’s how things are supposed to work. If there’s an issue, my pharmacy will call me. I received no such phone call Friday or Saturday, so on Sunday, I went to the pharmacy to pick up my prescription.
Not this time.
They are out of Qvar
“The Qvar is on backorder until the 13th,” the random pharmacy woman told me, after finally pulling herself from a conversation about their usual stores with the other random pharmacy woman I’d never seen before behind the counter.
“Will they call me when it comes in?” I asked, mentally trying to calculate an incalculable number of puffs remaining in my Qvar, given the inhaler has no counter.
Random pharmacy woman said something along the lines of she "doesn’t usually work here." I tried to gain some cred—and more accurately, some information—and said, “Well, they know me pretty well here.”
Not that this differentiated me from anybody else or give me frequent pharmacy patron miles, or anything.
Like many with a data-enabled phone in their hand, I opened up Chrome as I left the pharmacy:
- 12:03 PM - I last refilled my Qvar in July. I was eligible for a refill August 21.
- 12:07 PM - First visit to DrugShortages.Ca - Reports for Qvar - while getting a ride to the campaign office.
Result: Actual shortage as of June 24, 2019. Estimated end date: August 19, 2019 (as of August 14) updated from September 15 (as of June 29th).
- 12:30 PM - Google: "Qvar shortage", find little information.
Finding a solution
I was at a standstill for Sunday. But Monday, I got on the phone, first calling the Costco pharmacy to confirm this was indeed a widespread shortage. It was. I asked the helpful pharmacist if they had the 50 mcg in stock. They did.
I then called my pharmacy, and an awesome young pharmacist picked up (thank goodness). I explained the conundrum and told him I didn’t trust the drug would be available when they said it would. He agreed.
I asked if we could swap me over to the 50 mcg Qvar temporarily, doubling my dose. He also agreed. He said he would order it in, and he’d call my doctor just to let them know what was going on. I picked up my prescription on Wednesday: two Qvar inhalers to equate the one I’d usually get, instructions complete with a note to switch back to the 100 mcg when available.
As I am sure you all know by now, I need answers to stuff. Once I figured out the manufacturer of Qvar in Canada is no longer the one listed on the boxes (well, it is, but under a different name), I tracked down the “new” company. I sent them an e-mail on Monday, September 9th, asking for comment on the disruption to the supply. As of October 4, 2019, they still have not replied.
This is basically what I expected from pharma, and I’ll update here if I hear from them.
More drug shortages to come?
The staff member I picked my Qvar up from stated there’d been more and more drug shortages as of late. It's true: Canadian pharmacists have reported drug shortages have increased in the country in the last 3-5 years.1 I’ve also heard hints that there are more to come.
In the last 3 years, a quarter of Canadians or someone they know has experienced a drug shortage that directly impacts them.2 According to the Toronto Star, “Of the roughly 7,000 prescription drug products available in Canada, over 1,800 are shorted.”3
In an upcoming article, I’ll look into the reasons for why, exactly, these drug shortages happen—leaving patients and pharmacists in the lurch.
Have you ever experienced a drug you need being unavailable? What did you do?
Have asthma inhalers affected your dental health?