Drug shortage shows failure of leadership, critics charge

Supplier behind crisis could profit if its other plants land contracts
The prospect of Sandoz profiting from a nationwide drug shortage caused by its Canadian subsidiary shows a "shocking" failure of federal leadership, critics charge.
"It's shocking that the very company that caused the immediate crisis is the one that could benefit," said Libby Davies, the federal NDP health critic. "Patients and Canadians are being held captive, and I just don't think people will tolerate this."
Nonetheless, Canadians will likely have no choice but to pay higher prices to any company, including Sandoz, that receives federal approval to be an alternate source of the drugs that are in short supply, experts say.
"We got into this situation because Health Canada did not plan in advance, and now we're being held hostage," said Dr. Joel Lexchin, a drug-policy expert who has advised governments around the world. "We're now in a position where we have very few options."
As the Citizen reported last week, foreign manufacturing plants belonging to Sandoz, the generic-drug subsidiary of pharmaceuticals giant Novartis, represent the single largest group seeking Health Canada's permission to provide the medications that are in short supply.
The federal drug regulator is reviewing applications from companies that could fill the gap left by Sandoz Canada, which has slowed or discontinued production of more than 100 sole-sourced painkillers, sedatives and cardiac drugs used daily by hospitals across the country.
Of the 23 applications from drug makers that could ease the shortage, 15 are from Sandoz sourcing supplies from their foreign facilities, states Health Canada. That raises the possibility that the company at the centre of the crisis could gain financially from it.
Davies called on the Conservative government to honour an NDP motion, passed unanimously in the House of Commons last week, by investigating the root causes of the drug shortage.
"It does open the door for a much stronger response from the federal government, including an inquiry or investigation into what goes on in the drug industry," said Davies.
Conservative Health Minister Leona Aglukkaq declined the Citizen's request for an interview. However, in a brief statement, Aglukkaq indicated drug pricing is a provincial matter.
"Because it's the provincial and territorial governments that sign these agreements with drug companies, I'm not in a position to comment on whether one company or another would profit in a shortage situation like this," Aglukkaq said.
Lexchin, who teaches health policy at Toronto's York University, accused Aglukkaq of "passing the buck," saying Health Canada could have acted to prevent the drug shortage.
"Approving drugs and making sure that they're available in the country is the responsibility of the federal government," said Lexchin. "The provincial governments are buyers of the products, but they don't have any role in regulating what's available and what's not."
Among other things, said Lexchin, the federal regulator could have "proactively" drawn up a list of critical drugs that are provided by a single supplier and, in anticipation of a shortage, approved alternate suppliers rather than waiting for a crisis to react.
Not all experts are convinced Sandoz's foreign affiliates would automatically charge premium prices for the drugs that are in short supply, if they were given federal approval to be alternate vendors.
The bad publicity generated by the drug shortage might actually prompt Sandoz to fret about losing its preferred vendor status among Canadian hospitals, said Steve Morgan, associate director of the Centre for Health Services and Policy Research at the University of British Columbia.
"Maybe as a good corporate citizen, Sandoz might actually take a loss, or sell the product at its original price to win back the good will of the purchasers in Canada," he said.
By Pauline Tam
Ottawa Citizen
March 20, 2012