Mr. Speaker, I thank my hon. colleague from Vancouver East for taking the initiative with this evening's emergency debate on the drug shortage that Quebec is experiencing right now and that could affect the rest of Canada. As I rise here this evening to speak to this crucial issue, thousands of patients are wondering if their surgeries will go ahead as planned or if they will receive their cancer treatments.
Last week, dozens of surgeries in the Outaouais alone had to be postponed. At this time, Quebec hospitals are doing an inventory of their essential drugs in order to plan for possible shortages, and pharmacists are following the situation across Canada hour by hour. On voluntary disclosure websites that track drug availability, the list of drug shortages is now six pages long: pravastatin, fluconazole, dobutamine, feproz, amoxicillin and methotrexate, a drug used to treat leukemia that has been in short supply since last fall.
A number of health experts consider the current situation to be critical, but let us not forget, the current crisis is just the tip of the iceberg. Drug shortages have become more frequent over the past few years; since 2008, in fact. There are a number of reasons for this. There is the global shortage of molecules for producing drugs and the production shutdowns at certain companies for technical reasons or because of problems meeting quality and safety standards.
The situation at Sandoz in Boucherville, Quebec, falls into the last category. It was the United States Food and Drug Administration that criticized that pharmaceutical company's drug production methods, saying that the company did not satisfy American safety rules. The most troubling thing about this case is that the company knew for months that it had to make changes. The correspondence between the American agency and the company goes back to last November. Inspections were done in the summer of 2011. It was not until February 2012 that the information on the drug shortage at Sandoz was made public. Why did the company fail to inform the provincial and federal health authorities sooner? Did Health Canada know that the company was going to slow down production?
Obviously, the fire in the plant's roof did not help matters, but it is completely unacceptable that the governments, pharmacists, doctors and patients learned about the shortage at Sandoz so late in the game.
Let us not forget that Health Canada has a responsibility to ensure that the products offered on the Canadian market meet rigorous safety, effectiveness and quality standards. It is also the responsibility of the federal government to ensure that Canadians receive the health care they need. What is Health Canada doing to resolve the shortage problem? Not much for now. The federal government should show some leadership and work with the provinces to come up with a plan for the long term.
Currently, there are two websites for the voluntary disclosure of information about shortages. Pharmaceutical companies can use them to publish the names of their drugs for which production has slowed down or stopped. Unfortunately, the system is not reliable because there is also a shortage of information. Not all pharmaceutical companies contribute to updating the sites, and some refuse to disclose certain pieces of information.
Many stakeholders in the health care field are calling for better monitoring. Ontario's health minister, Deb Matthews, believes that there should be a mandatory drug information system. The Quebec order of pharmacists is calling for the same thing. The spokesperson for the Canadian Pharmacists Association, Jeff Morrison, called the existing system frustrating because it is up to drug companies to decide what information to share with the public. Today, the Canadian Cancer Society called on the federal government to fix the problem and released the following statement:
The Canadian Cancer Society believes that cancer patients must have access to high-quality, timely care no matter where they live in Canada. We are concerned and disheartened about reported drug shortages in Canada, including cancer drugs. For patients who are already going through a difficult time, not having access to appropriate drugs can be stressful and trying.
While the Society applauds the efforts being made by hospitals, doctors and pharmacists in dealing with this issue, we believe a national coordinated approach is needed to find effective solutions. Other countries have taken a more pro-active approach to drug shortages. The Society urges the Federal Minister of Health to provide leadership to address this critical healthcare issue...
When will the federal government take responsibility?
Ottawa cannot simply say that the supply issue falls under provincial jurisdiction, as we have been hearing for the past four or five days. Health Canada must work with the provinces and with the industry to find concrete solutions, particularly since this is a worldwide crisis and since closer co-operation with other regulatory bodies is vital to finding a sustainable solution right away.
But what is this government doing? It is in panic mode and so it finds a hasty solution by importing the injectable drugs that cannot currently be obtained on the Canadian market. This is a temporary and short-term solution that does nothing to resolve the problem in the long term. We must get to the root of the problem. One of the major causes of the drug shortage is the way the supply system operates in Canada. We should explain that bulk buying groups purchase drugs on behalf of hospitals. Clearly, buying in bulk reduces costs, which is a great benefit; however, the adverse effect of this way of doing things is that it considerably reduces the number of suppliers, as is the case with Sandoz in Quebec.
The drug shortage shows what can happen when we leave the market unsupervised and unregulated. Drugs are essential products upon which millions of Canadians depend. They are different from other goods. Dr. Peter Ellis, an oncologist at the Juravinski Hospital and Cancer Centre in Hamilton, believes that Health Canada must play a bigger role in this area. In his opinion, the only way to prevent future shortages is to better regulate the industry. This opinion is shared by SigmaSanté, the buying group that represents health institutions in the Montreal and Laval region.
While we wait for this government to finally realize that it is time to act, here are a few suggestions that may inspire the Minister of Health.
First, Health Canada could make a list of essential generic drugs. Before approving them, the department could require the pharmaceutical companies that produce the new versions of these drugs to commit to supplying them for five years.
Second, the federal government could ask companies for at least six months' notice—something like what is done in the United States—before they stop producing these drugs.
Third, Health Canada should always have a plan B because accidents can happen anywhere. A fire, contamination, a power outage—any of these things could have an effect on drug production.
Fourth, a government enterprise could also produce essential drugs to ensure a safe and continuous supply, as is currently done in Sweden.
The best solution is to enforce the regulations on an ongoing basis. We might wonder whether Health Canada has the means to do so. Need I remind the government that, last fall, the Auditor General sounded the alarm with regard to the drug verification process? He said:
The Department does not take timely action in its regulatory activities...In particular, the Department is slow to assess potential safety issues. It can take more than two years to complete an assessment of potential safety issues and to provide Canadians with new safety information.
If problems were identified sooner, as they arose, then catastrophe could be averted and the problems addressed gradually. It is high time for Health Canada to take action. It is the federal government's responsibility to work with the provinces and with the industry to find solutions to the drug shortages.
I hope we will be able to reach conclusions and learn lessons from this crisis because this is about Canadians' health—the health of all patients who need drugs for their well-being.
I hope that the Conservatives opposite will follow suit and find solutions that are more sustainable than importing drugs from other countries. I hope that they will introduce more effective monitoring to ensure a sustainable, long-term plan so that people can get the care they need.