The revelation that a major drugmaker is cutting production at its Quebec plant has ramped up fears among doctors and patients about a critical shortage of injectable medicines nationwide.
Supplies have already dried up for some pharmacies seeking to stock up after Sandoz Canada — one of the country's leading suppliers of generic cancer and heart medications — announced Sunday it was temporarily suspending production at its Boucherville, Que., facility.
Larissa Feldman's Montreal drugstore was among those left in the lurch by the sudden stoppage, which health-care providers fear could last months.
"This morning, we've tried to order some of these products. Not to our surprise, there was none available," Feldman said. "We are the first line for the patient. The patient will come to us expecting their medication, and we will not have it."
'Significant reduction in output'
The company said it was expecting "a significant reduction in output" and was halting production lines to upgrade operations after quality-control assessments by the U.S. Food and Drug Administration warned the factory fell short of FDA standards.
During inspections this summer, the U.S. regulator found the plant had failed to prevent contamination in some drugs and did not alert the agency quickly enough. However, no products were recalled.
About 800 people work at the Boucherville plant, which manufactures common medications such as those used to relieve pain and nausea experienced by chemotherapy patients.
Some products will be discontinued, while others will resume production once the suspension is lifted, although Sandoz has not clarified which drugs will go out of production.
The company said in a statement it would prioritize production of its most critical drugs.
Scrambling to find alternative drugs
"We will focus all available capacity on the supply of life-saving and acute care injectable medicines to ensure that Canadian patients with critical medical conditions continue receiving adequate treatment," the statement read.
In the mean time, physicians are scrambling to find replacement therapies to treat certain ailments.
Feldman said pharmacists will have to consult closely with doctors to ensure they prescribe alternative medications, if they're available.
"We call the hospital, we call other pharmacist colleagues, and we try to find the medication," she said.
The latest slowdown comes amid a global shortage hitting the pharmaceutical industry, but health-care providers have complained they often receive little warning ahead of major production trims from drugmakers.
Early warning system urged
Dianne Lamarre, president of the Quebec Order of Pharmacists, said that kind of timely information could be used to seek out backup drugs and alternatives in the marketplace.
She has called for the creation of an early warning system to signal when a specific drug is in short supply. Such a system would require unprecedented co-operation among competing drug companies.
"We need a special agency which will ensure a follow-up with industries, which will make Health Canada react more quickly when essential drugs are not available," Lamarre said.
She told The Globe and Mail newspaper she expects some production lines will be running at half capacity.
The Canadian Pharmacists Association is also urging Health Canada to force pharmaceuticals companies to provide notice of changes to production and inform doctors long before they discontinue certain drugs.