Social Policy in Ontario

Play hardball with lax drugmakers

Posted on February 17, 2015 in Health Policy Context

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TheStar.com – Opinion/Commentary – After years of deference to global drugmakers, Canada finally shows some — but not enough — backbone.
Feb 17 2015.   By: Carol Goar, Star Columnist

If you need penicillin, you’re out of luck. It’s been unavailable since last July. If you develop a serious bacterial infection — bronchitis, pneumonia, diverticulitis — your doctor won’t be able to treat it with penicillin, one of the most effective antibiotics on the market. It is out of stock, too. If your child requires penicillin, you’ll have a tough time finding any until mid-May.

The problem is not confined to everyday medications. In recent months there have been interruptions in the supply of chemotherapy components, anti-seizure medications, blood thinners, anesthetics and other life-saving medicines.

And those are just the shortages medical professionals know about. Some catch them off-guard, throwing hospitals into crises and leaving patients in the lurch.

Drug scarcities are not new but the number and duration have risen sharply in the last five years. Doctors used to scramble to find medicines for rare diseases or drugs that could be safely combined for patients with concurrent conditions. Now common pharmaceutical products — on the market for years — have disappeared from drugstores and hospitals. “Penicillin was invented in the ’40s the last time I checked, so I don’t think it should be that difficult to produce,” Edmonton emergency room doctor Louis Hugo Francescutti then-president of the Canadian Medical Association, said last spring.

Last week, federal Health Minister Rona Ambrose took a long-overdue step to help doctors and patients manage the supply interruptions. She made it mandatory for drug manufacturers to alert doctors and the public to current and anticipated shortages (as it is in the United States). “Now, for the first time, we have a clear protocol that outlines roles, responsibilities and details on how we communicate so that Canadians are receiving the most up-to-date information,” she said.

Pharmaceutical companies that fail to provide timely notification of shortages will be “named and shamed,” she added.

By past standards, Ambrose’s move is welcome. Her predecessor, Leona Aglukkaq, dismissed calls for mandatory reporting on the grounds it would “take too long.” Under the new reporting procedure, doctors will have more time to find alternatives and patients get a heads-up to renew their prescriptions before supplies dry up. But given the seriousness of the problem, the minister’s intervention begged a bigger question: Is this all Ottawa can do?

– Why not impose tough penalties on drug makers that cut off supplies abruptly with no explanation or warning? Public exposure isn’t likely to influence pharmaceutical giants that brazenly price life-saving drugs out of the reach of dying patients; embarrass generic drugmakers that blithely sell products flagged as unsafe by the U.S. Food and Drug Administration; or shame globe-straddling corporations that disrupt medicare without apology or regret. They are impervious to moral suasion. They live by the bottom line.

– Why not set performance standards for the $2 billion Ottawa doles out to the pharmaceutical industry every year? Drug manufactures might improve their practices if their federal subsidies were at stake.

– Why not challenge the excuses drug companies are making? They blame everything from regulatory barriers to group purchasing for their failure to deliver once-accessible drugs reliably. But the evidence shows that they stop producing drugs that aren’t sufficiently profitable and take their time rectifying safety issues. They can adapt to bulk-buying. They don’t need any more concessions than they have secured from every government, including Canada’s.

– Why not join forces with other countries experiencing drug shortages to tackle the “supply chain issues” that are interrupting the flow of vital medications? Canada can’t stand up to the global pharmaceutical giants alone. It will take the combined muscle power of multiple governments to get relief.

– Why not enlarge the stockpile of drugs kept by the Public Health Agency of Canada? The federal institution has a limited supply of emergency medications for pandemics, terrorist attacks and natural disasters. As drug shortages multiply, it may need to be expanded.

= Why continue to treat the pharmaceutical industry with deference? It is no longer a job creator; over the past five years employment has fallen by 6.3 per cent. Nor is it an innovator; since the turn of millennium its research spending has dropped by 29 per cent.

It is true the minister’s leverage is limited. She can’t compel globe-straddling private corporations to minimize the distress they are causing in people’s lives. She can’t force them to act in the public interest.

But Ambrose is not powerless. Canada is the ninth largest pharmaceutical market in the world. It accounts for $22 billion in annual sales.

Drugmakers can’t afford to ignore muscular pushback from one of their biggest customers.

< http://www.thestar.com/opinion/commentary/2015/02/17/play-hardball-with-lax-drugmakers-goar.html >

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