Tier 3 drug shortages
Tier 3 shortages are those that have the greatest potential impact on Canada's drug supply and health care system. Medical necessity and low availability of alternative supplies, ingredients or therapies determine the degree of impact.
The Tier Assignment Committee (TAC) includes federal, provincial and territorial governments, health care professionals and industry stakeholders. TAC makes recommendations on the tier assignment of actual and anticipated drug shortages based on:
- a review of the information gathered on the drug shortage
- a thorough discussion of the potential impact of the shortage
- a discussion of next steps to be taken to mitigate the impact of the shortage
Drugs in or at risk of Tier 3 shortages may be eligible for exceptional importation and sale. For more information, please consult the Guide to the exceptional importation and sale of drugs in response to drug shortages (GUI-0148).
Drugs that are allowed to be imported and sold in order to mitigate a critical shortage are found on the List of drugs for exceptional importation and sale.
| Drug (Active Ingredient) | Date of Tier 3 Determination | TAC Committee Membership | Used in the treatment of COVID-19 and/or related conditions (Yes/No) |
|---|---|---|---|
| Calcitonin - Calcimar | March 25, 2025 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Rheumatology Association, Canadian Society of Endocrinology and Metabolism | No |
| Hydroxocobalamin powder for infusion | December 10, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Healthcare-Systems Pharmacy, Canadian Association for Poison Centres and Clinical Toxicology | No |
| Oncaspar - Pegaspargase | Proactively assigned, November 28, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Healthcare-Systems Pharmacists, Canadian Association of Provincial Cancer Agencies | No |
| Peginterferon Alfa-2A | November 25, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Healthcare-Systems Pharmacy, Canadian Association of Provincial Cancer Agencies | No |
| Alcaine - Proparacaine Hydrochloride Ophthalmic Solution | January 30, 2025 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Healthcare-Systems Pharmacy, Canadian Ophthalmological Society | No |
| Anagrelide | April 15, 2025 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Healthcare-Systems Pharmacy, Canadian Association of Provincial Cancer Agencies, Canadian Myeloproliferative Neoplasms Network | No |
| Salbutamol | January 17, 2025 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Pharmacists Association, Canadian Society of Healthcare-Systems Pharmacy | No |
| Aldesleukin | October 10, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Association of Provincial Cancer Agencies | No |
| Idarubicin | September 20, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society for Hospital Pharmacists, Canadian Association of Provincial Cancer Agencies | No |
| Methotrexate preservative free | September 20, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society for Hospital Pharmacists, Canadian Association of Provincial Cancer Agencies | No |
| Pantoprazole Sodium for Injection | June 20, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Association of Gastroenterology | No |
| Lithium Carbonate | July 25, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Pharmacists Association, Canadian Psychiatric Association | No |
| Lomustine | August 6, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Pharmacists Association, Canadian Association of Provincial Cancer Agencies | No |
| Glucagon for Injection, rDNA origin | April 20, 2023 | Health Canada, British Columbia Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Pediatric Endocrine Group, Canadian Society of Endocrinology and Metabolism | No |
| Apomorphine Hydrochloride | November 14, 2023 | Health Canada, British Columbia - Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Pharmacists Association, Parkinson Canada | No |
| Eluxadoline - Viberzi | September 20, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Pharmacists Association, Ontario Association of Gastroenterology | No |
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