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) |
|---|---|---|---|
| Mepivacaine hydrochloride injection, 20 mg/mL | June 7, 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 Anesthesiologists Society | No |
| Loxapine hydrochloride; Loxapine succinate | May 17, 2024 | 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 Hospital Pharmacists, Canadian Psychiatric Association | No |
| Epinephrine injection 1 mg/10 mL pre-filled syringes | June 19, 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 |
No |
| Carbamazepine Controlled Release, tablets | May 10, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Pharmacists Association, Canadian League Against Epilepsy | No |
| Bupivacaine with Epinephrine | May 7, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society Hospital Pharmacists, Canadian Anesthesiologists' Society | No |
| Abatacept solution for subcutaneous injection | April 22, 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 Rheumatology Association | 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 |
| Colesevelam | Proactively assigned, February 15, 2024 | 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 Hospital Pharmacists, Canadian Association of Gastroenterology | No |
| Tamsulosin Hydrochloride | January 26, 2024 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Pharmacists Association, Canadian Urological Association | No |
| Cholestyramine | January 26, 2024 | 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 Hospital Pharmacists, Canadian Association of Gastroenterology | No |
| Colestipol | Proactively assigned January 26, 2024 | 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 Hospital Pharmacists, Canadian Association of Gastroenterology | No |
| Prazosin 1mg, 2mg, 5mg Tablets | May 19, 2023 | 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 Pharmacists Association, Canadian Cardiovascular Society, Department of National Defence | 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 |
| Argatroban for Injection | May 8, 2023 | Health Canada, British Columbia Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Hematology Society | 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 |
| Calcium Chloride Injection | August 24, 2023 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists | No |
| Dextrose Injection | August 24, 2023 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists | No |
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