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) |
|---|---|---|---|
| Sodium Thiosulfate – Technetium TC 99M TSC | May 6, 2022 | 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 Nuclear Medicine | No |
| Hydrocortisone Tablets (Cortef) | April 25, 2022 | Health Canada, British Columbia Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Endocrinology and Metabolism | No |
| Sterile Water for Injection (small volume formats) | March 17, 2022 | Health Canada, British Columbia Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Mohawk MedBuy, HealthPro | Yes |
| Calcium Gluconate Injection | March 10, 2022 | Health Canada, British Columbia Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, |
No |
| Alprostadil Sterile Solution | February 25, 2022 | 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 Paediatric Society | No |
| Sodium Chloride 0.9% USP Injectable - Diluent | January 20, 2022 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Public Health Agency of Canada | Yes |
| Asparaginase - Erwinase | July 16, 2020 | Health Canada, Ontario Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Association of Provincial Cancer Agencies | No |
| Continuous Renal Replacement Therapy Solutions - PrismaSOL 0, PrismaSOL 4, Prism0CAL and Prism0CAL B22K0/0 | Proactively assigned June 2, 2021 | 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 Society of Nephrology | Yes |
| Decitabine/Cedazuridine tablets | Proactively assigned January 26, 2022 | 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 Provincial Cancer Agencies | No |
| Hydralazine Injection | November 26, 2021 | 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 Cardiovascular Society |
No |
| Medroxyprogesterone Acetate - Injectable suspension | Proactively assigned March 18, 2021 | Health Canada, Ontario Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Society of Obstetricians and Gynaecologists of Canada | No |
| Methotrimeprazine Hydrochloride Injection | February 17, 2022 | 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 Society of Palliative Care Physicians |
No |
| Morphine Sulfate Capsules - Sustained-Release | May 31, 2021 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association Canadian Medical Association, Canadian Society of Addiction Medicine |
No |
| Moxifloxacin Injection | November 4, 2021 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Association of Medical Microbiology and Infectious Disease Canada | No |
| Papaverine Hydrochloride Injection | April 28, 2022 | Health Canada, British Columbia Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Society of Cardiac Surgeons | No |
| Levofloxacin Injection | November 4, 2021 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Association of Medical Microbiology and Infectious Disease Canada | No |
| Propylthiouracil | May 25, 2020 | Health Canada, Ontario Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Endocrinology and Metabolism, Canadian Society of Hospital Pharmacists | No |
| Remifentanil Hydrochloride Injection | February 24, 2022 | 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 Anesthesiology Society | No |
| Sarilumab | April 27, 2021 | Health Canada, British Columbia Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Pharmacists Association, Canadian Rheumatology Association, Canadian Society of Hospital Pharmacists | Yes |
| Tocilizumab for Injection (IV) | February 19, 2021 | Health Canada, Ontario Ministry of Health representing the Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Pharmacists Association, Canadian Rheumatology Association | Yes |
| Lurbinectedin (Zepzelca) | Proactively assigned April 13, 2022 | Health Canada, British Columbia Ministry of Health representing Provincial and Territorial Drug Shortage Task Team, Canadian Medical Association, Canadian Society of Hospital Pharmacists, Canadian Association of Provincial Cancer Agencies | No |
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