The Canadian Pharmacists Association is warning that medication shortages have become a serious problem for pharmacists, causing stress for patients, and sometimes forcing doctors to prescribe less effective drugs.

The pharmacists' group has released a survey of 427 pharmacists conducted in October 2010, on the subject of drug shortages. It finds that 81 per cent of pharmacists report they've had trouble locating a medication, with 93 per cent saying they had trouble finding medication in the past week.

A full 89 per cent of pharmacists feel that the shortages had greatly increased in the last 12 months, while another 8.2 felt shortages had increased somewhat.

"Shortages are also an extremely serious concern for pharmacists directly, and are causing widespread frustration," the report says.

Ontario appears to be suffering from shortages somewhat more than other provinces, with pharmacists there reporting higher rates of having trouble locating a medication than in other provinces. And it's affecting all pharmacies, from chain stores to independent dispensaries.

When asked whether patients' health outcomes have been adversely affected, 70 per cent of pharmacists said yes. In some cases, patients have been offered alternative drugs that have been less effective; in other cases, there has been no alternative medications available at all. In some of the worst cases, hospitalization of the patient was required.

Patients and pharmacists are also being forced to call around to find our which stores have the needed medications. And at times, patients having to switch to alternative medications are finding they're not covered by public or private drug plans.

The report notes that drug shortages are not a Canadian phenomenon; they are occurring in countries around the world -- particularly in the United States, "at apparently similar levels of frequency and duration."

Antidepressants, antibiotics, and heart medications were among the medications in shortest supply over the past several months, the pharmacists reported. They include the antidepressant amitriptyline, the anti-nauseant metoclopramide, the blood pressure medication clonidine, and the antibiotics tetracycline and cephalexin.

The report offered a number of reasons for the shortages, including:

  • shortages of raw materials used in drug manufacturing
  • more stringent regulatory requirements that delay production
  • problems with manufacturing processes in specific plants that have delayed delivery of supply
  • the introduction of new pricing regimes in provinces that act as a disincentive to production of particular drugs
  • an increase in product recalls in Canada or elsewhere
  • monopolization of production of a particular drug by manufacturers
  • shortage of proper container materials

"Given the absence of reliable data from all the parties involved in the drug supply chain, it is difficult to pinpoint more exact causes of the current round of shortages," the report says.

Further compounding the stress is the fact that drug manufacturers are under no obligation to let pharmacists, doctors and patients know where there's going to be a disruption in supply of a particular medication.

"Due to the reluctance of individual manufacturers to share information on supply and manufacturing problems, it is difficult to predict when shortages will occur, for how long, and affecting which drugs," the report notes.

Dr. Jeff Poston, the executive director of the Canadian Pharmacists Association, says he hopes the report compels some changes.

"This report should serve as a wake up call to everyone involved in the drug distribution system that shortages are a serious concern, and that solutions need to be developed," he said.

"One immediate step that needs to be taken is for governments to regulate a greater scope of practice for pharmacists, so that pharmacists can use their specialized skills and training to help patients deal with a shortage when it arises."