Drug shortages in Canada: Fiscal year 2022 to 2023 in review

Organization: Health Canada

Date published: 2023-11-06

On this page

• What is a drug shortage
• How Health Canada addresses shortages
• Drug shortages in 2022 to 2023
• Shortages with the highest impact
• Highlights of 2 high-impact shortages

What is a drug shortage

Over 9,000 prescription drugs and 2,000 over-the-counter drugs are approved for sale in Canada. This number varies as new drugs are approved and others are discontinued.

A drug shortage is when there’s not enough supply of a drug to meet demand. Some shortages can last longer and are more complex than others. A shortage can impact anyone, such as:

• patients
• parents
• caregivers
• healthcare providers

Not all shortages are a cause for concern as most shortages are successfully managed before they impact patients.

How Health Canada addresses shortages

For certain drugs, manufacturers must report anticipated and actual drug shortages and discontinuations on the drug shortage reporting website.

To help prevent, mitigate and resolve shortages, Health Canada works closely with:

• provincial and territorial governments
• manufacturers
• the healthcare system
• healthcare professionals
• patient groups
• our global partners

It’s our top priority to try to prevent shortages when possible. We also take actions to mitigate their most severe impacts when they present a significant risk to patients and the healthcare system.

Learn more:

• Infographic: Helping Canadians deal with drug shortages

Drug shortages in 2022 to 2023

In 2022 to 2023, over 2,700 drug shortages were reported.

Companies need to report each time they cannot fully meet the demand for their drug. Not all reports are cause for concern for patients as many of the same drugs are available in different formats or quantities. Most shortages are successfully managed before they impact patients.

Top 3 reasons for shortages

1. Manufacturing problems
2. Unexpected increases in demand
3. Shipping delays

Duration

The average length of a drug shortage reported during this period was 98 days.

Shortages with the highest impact

Drug shortages with the highest potential impact are called Tier 3 shortages. Among all reported shortages, only a small percentage have a high impact on patients and the healthcare system.

From 2022 to 2023, those shortages with the highest impact made up 0.4% of all marketed prescription drugs.

Of the 34 drug shortages that had the highest impact on patients and the healthcare system:

• 23 were resolved within the reporting period, including intravenous and oncology drugs
• 11 shortages remain active, with mitigation efforts under way to resolve them

During this reporting period, Health Canada:

• identified alternative drugs and sped up the review process for new drugs to support patients
• conducted active monitoring and shared information when we needed to take exceptional measures and confirmed these measures were effective
• authorized the importation of similar drugs approved in foreign jurisdictions by trusted partners through exceptional importation and sale measures
• facilitated continued access to these drugs through conservation and shelf-life extension with supporting data

Highlights of 2 high-impact shortages

Two examples of high-impact shortages over this period include:

• pediatric analgesic shortage
• Rifampin shortage

Pediatric analgesic shortage

An unprecedented increase in demand caused the shortage of children’s and infants’ pain and fever reducing medications from August 2022 to March 2023.

We took the following actions:

• mobilized and shared information regularly with a broad range of stakeholders on incoming supply, demand forecasts and key actions to improve access for Canada’s 5 million children under the age of 12
• worked with manufacturers to increase supply to record levels
  • 12.3 million units delivered between November 2022 and March 2023
• authorized the importation of 3.5 million units of foreign-authorized pain and fever reducers between November 2022 and March 2023
• worked with distributors to monitor inventories and speed up distribution
• shared information and updates with provinces and territories, doctors, pharmacists and parents/caregivers

We continue to work with stakeholders to make sure there will be an adequate supply of these drugs for the 2023 to 2024 cold and flu season.

Rifampin shortage

During the winter of 2023, Canada experienced a shortage of Rifampin, which is used to treat tuberculosis. The shortage was the result of manufacturing issues.

The shortage could have greatly impacted certain rural and Indigenous communities with higher rates of tuberculosis infections.

We took the following actions:

• mobilized and shared information regularly on the supply situation with a range of stakeholders
  • This helped facilitate implementation of mitigation measures and conservation strategies, and adoption of best practices.
• worked with the provincial and territorial governments and the manufacturer to prioritize shipments of available supplies to locations with the greatest need
  • This helped locations with lower inventories avoid depleting their supply.
• worked with the manufacturer, wholesalers and distributors to monitor inventories and restock supplies quickly

The shortage was resolved in spring 2023.