Thank you for inviting the Canadian Pharmacists Association to appear today, during this rather unusual time.
I'm Dr. Barry Power and I’m joined by my colleague Dr. Shelita Dattani. We are here on behalf of our 43,000 pharmacist colleagues from every province and territory.
We’d like to start today by giving you a quick glimpse into the lives of pharmacists, about 80% of whom are in community pharmacies and close to 15% are in hospitals. We would also like to touch on three issues that are front and centre for pharmacists and their teams at this time.
What are we seeing in pharmacy? The last few weeks have been very intense, to say the least. We have seen an incredible surge of people coming into our pharmacies across the country seeking help and support. They are often scared and concerned that they can’t get through to the 811 line or to their doctor's office, which is closed, and they or a family member are sick and need help. We are there for them. We are answering their questions, allaying their fears and providing the care they need.
Pharmacies are also trying to adapt quickly to the changing environment and needs of their patients. To create a safe space for clients, many pharmacies have implemented special hours for seniors and other at-risk individuals. They're adding additional cleaning and disinfecting procedures, often after hours, and are coming up with innovative ways to support physical distancing, like curbside pickup. I've never been so proud of those in my profession who are on the front line and who are showing up every day to work. Unlike many of us who can work from home, they cannot, so we’re very humbled to be able to have this opportunity to bring forward some of the major issues and challenges they are experiencing at the moment.
One of the things pharmacists are most concerned about during this pandemic is ensuring all Canadians have access to their medications. We've seen a number of troubling trends over the past few weeks. The first sign came about six weeks ago, when almost overnight the supply of masks, hand sanitizer and gloves were sold out. Then about three weeks ago, as public health officials started to implement social-distancing policies across the country and recommend that people stockpile food and medications, the demand for medications skyrocketed. What we saw was the volume of demand increase by over 200% in March, threatening the integrity of our drug supply chain. If left unchecked, we would have run the risk of running out of medications for our patients.
For fear of medications becoming the next toilet paper, we quickly took action by recommending a temporary 30-day supply limit for medications. This was critical to protect supply chains, address panic buying and most of all to ensure that patients would continue to have access to their drugs in the coming weeks. In addition to the need to manage demand, we are also concerned about the increase in drug shortages. In the months leading up to March, the government’s mandatory drug shortage website was listing approximately five new shortages per day. In the last few weeks, the number has increased about 35%, and we are seeing some early signs that those shortages have increased more rapidly in the first few weeks of April. That is in addition to some of the shortages that we’ve already seen of medications that are being used directly to treat COVID.
Currently, Health Canada has identified three such COVID-related severe shortages. First is hydroxychloroquine, the subject of much press, having been touted by some prominent figures as a cure to COVID. While there is currently no evidence that this is the case, the demand for hydroxychloroquine is now making it difficult for patients who rely on this drug for conditions like rheumatoid arthritis or lupus.
Second is inhalers used for asthma and COPD. The demand for inhalers in the last few months has increased significantly, both from hospitals as they prepare for COVID and in the community setting as people stockpile medications.
Third is medications being used in hospitals, particularly the sedative medications used in ICU settings for ventilated patients, drugs such as fentanyl and propofol.
COVID is and continues to be a threat to Canada’s drug supply. We recognize that measures such as the 30-day supply impact patients. Thus, we have been urging governments and private insurers to ensure no patient is out of pocket for the additional costs associated with the 30-day supply. Thankfully, progress is being made to address this concern.
We also want to minimize the risks to patients who might need to refill their prescriptions by visiting pharmacies more often. I’ll turn it over to my colleague Shelita to address this issue.