Mr. Speaker, we are here this evening to discuss drug shortages. We have to understand and talk about the fact that the pharmaceutical industry supplies drugs and decides which drugs and how much of them to produce.
The pharmaceutical industry is in the best position to monitor actual and potential drug shortages and to share that information with stakeholders.
We would not be here tonight if the industry had done that. The industry is responsible for the nationwide drug shortages. Our government is very disappointed that Sandoz failed to fulfill its commitment to provide timely, accurate information about actual or potential drug shortages.
We believe that Sandoz could have prevented the shortage by issuing a press release about changes to its drug production volumes. Sandoz's failure to communicate made it even harder for patients and our health system to deal with a difficult situation. Our government is responsible and must ensure that there is no threat to the health of 34 million Canadians or the system they rely on.
Our current system is facing many complex, closely related challenges that create the conditions conducive to drug shortages. Production delays or the discontinuation of products are the factors contributing to shortages that are most commonly cited by Canadian sources. This problem is certainly not unique to Canada. This is a universal phenomenon that results from the ever-increasing globalization of the supply chain.
Despite these global challenges, we would be remiss if we did not draw attention to the shortcomings of Sandoz at the local level that contributed to the drug shortages we are currently experiencing. When Sandoz decided to stop production in response to concerns raised in a letter from the Food and Drug Administration in the United States, a letter that indicated that Sandoz was not following good manufacturing practices, did it consider the consequences this decision would have for the Canadians who need its products?
According to responsible business practices, a company with an international clientele, like Sandoz, must think about its responsibilities to all the patients who use its products, whether American or Canadian.
When a manufacturer makes decisions regarding the production of drugs used in hospitals to treat serious diseases, does it ensure that its clients, hospitals, have an adequate stockpile of drugs before stopping production?
Based on what happened at Sandoz, the only answer to this question is no. One of the disadvantages of the fact that the industry is always trying to improve efficiency is the risk of disruption. And when this disruption happens, there is a good chance that the supply chain will suffer.
How many of these companies get their raw materials from a single source or a limited number of sources? By limiting the number of their suppliers, manufacturers are exposed more to supply interruptions. When they can, companies should have more than one supplier of their basic ingredients.
This principle also applies to drug purchasers, including hospitals and drug benefit plans. That is why the government asked Sandoz to look in Canada and abroad for other suppliers or other facilities that could quickly produce the most essential drugs in order to minimize the impact this would have on patients in Canada.
Have Canadian manufacturers put in place appropriate contingency plans in the event of a disruption in supply? Again, the Sandoz case would suggest not. If Sandoz had had risk mitigation strategies, the current situation could have been avoided.
Unfortunately, doctors and pharmacists are now in a delicate situation. They have to make substitutions using only the stock they have on hand. If the manufacturer had warned them early enough, they would have been better prepared and could have made other arrangements.
These companies know how much their products are needed. Although they do not see every patient who benefits from their products, they should not forget that the victims of their lack of transparency and lack of honest communication are the patients.
Sandoz failed to follow a best practice we expect from a global company. As it was focusing exclusively on upgrading its equipment and on opening up the U.S. market for its product, it ignored the effects this would have on Canada. The consequences are unacceptable.
Sometimes unethical business practices are used after a manufacturer issues a notice of a drug shortage.
For example, some wholesalers might procure drug reserves at a reduced price in anticipation of a possible change in price by a manufacturer in order to maintain their profit margins. Rumours of price increases could also cause pharmacists to build up reserves.
One would hope that all parties put the patients' needs above profits, because health and safety must come first.
The Government of Canada encourages its industry partners to be more transparent when it comes to their manufacturing processes and to be more communicative about them.
We are also working with our provincial and territorial partners to increase the number of drug production sources because when we rely on sole sources we are more vulnerable to shortages.
In that regard, the Minister of Health has told the provinces and territories a number of times to enhance the efficiency of their system.
Even though negotiating contracts with a sole drug supplier can indeed result in cost savings in the short term, those savings must not open the door to risk or higher costs in the long term.
For that reason the federal government strongly encourages provincial and territorial health authorities to obtain drugs from several suppliers in order to avoid being vulnerable to interruptions in the production of a single supplier.
All health professionals working in the system and their associations are already doing everything in their power to ensure that patients get the treatment they need. However, the lack of coordination of time-sensitive communications increases the burden on the system.
In the end, Canadians will pay for this weakness in the system: they will either have to pay more for expensive substitutes, or their health will be compromised because of delayed treatment.
That is why greater transparency is needed throughout the supply chain and there must be better communication on the part of industry. The industry must honour its commitments with respect to clear, transparent and timely communication of all information on current and potential drug shortages.
The federal government has thus insisted that Sandoz use public websites for reporting drug shortages to provide that information so that health professionals have access to the information they want.