Health committee  I'm not aware of which body would do that. I think the drug manufacturing associations probably have a better sense than we have. Certainly, as a health care professional, I have no idea. This number that I quoted earlier about the 70% was big news to me when I learned that a couple of months ago.

Health committee  I think the suggestion probably came from the Canadian Pharmacists Association. It may be that we did write to Minister Aglukkaq about a month ago, jointly with the Canadian Pharmacists Association. In that letter we did raise the issue that drug shortages are a global problem and finding global solutions should be something that should be addressed through the WHO.

Health committee  Not to my knowledge, no.

Health committee  Our association has been a member of that multi-stakeholder working group since last spring, so I can speak to that. Although I think we've made significant strides towards having a drug supply management system, as was mentioned earlier, currently we have a temporary arrangement with two existing drug shortage or drug supply systems.

Health committee  I think I'll restate what I said before. We're health care practitioners. We're not fully familiar with how all the political systems work and how the health care systems work around the world. That is Health Canada's responsibility. If there are solutions and there are other countries that have systems similar to ours and we can learn from their system, that is what we expect Health Canada to do.

Health committee  If you're asking about the current temporary solutions that we've put in place, as was mentioned, Saskatchewan Drug Information Services is one option. The other group we've made arrangements with is a group from Montreal; the database is called fridaypm.ca because typically when all hell breaks loose it's on Friday afternoon.

Health committee  International manufacturing corporations?

Health committee  I think cooperation is critical. As I said, this is a global problem and it calls for global solutions. Discussion needs to happen at a global level. And to answer your previous question, certainly health care practitioners don't have these solutions. As Dr. Haggie said, we're the front-line practitioners.

Health committee  It's one major cause, but it's not the only cause. There are multiple causes to drug shortages, as I'm sure you are aware. Some causes are national and could be dealt with within Canada, but many causes are global and need to be dealt with globally. I've heard that 70% of drug products that are supplied here in Canada are actually partially or completely produced elsewhere, outside of Canada.

Health committee  Madam Chair, honourable members, ladies and gentlemen, I thank you for the opportunity to present to you today. My name is Myrella Roy, and I am the executive director of the Canadian Society of Hospital Pharmacists, also known as CSHP. Before accepting this position, I spent 17 years as a hospital pharmacist and clinical manager with the Ottawa Hospital.

Health committee  This is something to which I referred in my presentation. Obviously, we already have the MedEffect database; however, it unfortunately has a number of shortcomings. While it facilitates the reporting of new reactions for both health care professionals and consumers, it is difficult to use the information as there is so much of it.

Health committee  To come back to your example of declaring a rash, currently, as with the definition that's proposed by Health Canada in their MedEffect database, if a rash causes the patient to stay longer in the hospital, this is considered a serious adverse drug reaction and should be reported.

Health committee  Your question is whether or not pharmacists should be remunerated? I don't think I mentioned that at all in my intervention, but I don't think that hospital pharmacists--and I'm pretty sure I can speak for all of my colleagues in community pharmacy as well--consider adverse drug reaction reporting as part of our duty, and we are not expecting to be remunerated for that.

Health committee  I would support as well what Jeff has just mentioned, because right now the current system we have focuses only on pre-marketing surveillance, not post-marketing, although there is a little bit of effort there, but not as much, and as Manon mentioned earlier, because there are only a small number of patients who are exposed to the medications pre-marketing, we have limited information.

Health committee  In the case of the two examples I provided, we know, for example, that chemotherapy agents can cause a lowering of blood cell counts in probably almost 100% of patients. Will one more report to tell us that it is 100% assist us? Also, serious bleeding from warfarin can occur in a significant number of patients, so is “significant” 45% or 50%?