Provincial/Territorial Perspective Drug Shortages: BC and Beyond Elaine Chong, British Columbia Ministry of Health 2017 CADTH Symposium April 24, 2017

Overview Collaborative Context Provincial/Territorial Drug Shortages Task Team British Columbia Initiatives Case Studies Discussion and Questions

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Acknowledgements British Columbia Ministry of Health Ms. Darlene Arenson Ms. Barbara Walman

Manitoba Health, Provincial Drug Programs Ms. Joan Blakley Ms. Bernadette Preun

PT Drug Shortages Task Team Colleagues Health Canada Mr. Michael Carter Mr. Ed Morgan

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TIER 1 • Anticipated

TIER 2 • Actual

TIER 3 • Actual with

Greatest Potential Impact

Collaborative Context Multi-Stakeholder Steering Committee on Drug

Shortages (MSSC) Manitoba is the current Provincial/Territorial Co-Chair British Columbia was the previous Co-Chair

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Provincial/Territorial Drug Shortages Task Team Formed in 2012 Mandate: to help identify, prevent, alleviate, and

resolve drug shortage situations that have a significant effect on public health

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Provincial/Territorial Drug Shortages Task Team Share, develop, negotiate, and deliver P/T

intergovernmental plans, projects, strategies and initiatives on drug shortages Strategic analysis, expertise, and advice to P/T

Executives, Deputy Ministers, and Ministers

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Provincial/Territorial Drug Shortages Task Team Collaborate with the federal government

(primarily Health Canada and the Public Health Agency of Canada) and non-governmental organizations to address and resolve drug shortages

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Provincial/Territorial Drug Shortages Task Team Manitoba is the current chair British Columbia was the previous chair (2014 to

2016) Membership includes P/T Ministries of Health,

regional health authorities or hospitals, as well as procurement agencies

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Provincial/Territorial Drug Shortages Task Team Core Responsibilities Communicate, identify, track, respond Escalate Collaborate

Meetings by teleconference every 2 weeks Input into https://www.drugshortagescanada.ca/

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RESOLVED National

Drug Shortages

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ACTIVE National

Drug Shortages

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ONGOING National

Drug Shortages

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Sept 2014 – Aug 2016

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RESOLVED National

Drug Shortages

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ACTIVE National

Drug Shortages

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ONGOING National

Drug Shortages

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Sept 2016 – Mar 2017

British Columbia Initiatives Collaboration with stakeholders (e.g., BCPhA) Recognition of need to make drug shortage

information more accessible Increased frequency and duration of shortages Rapid changes and multiple sources of information Limited avenues to communicate changes in real-time

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British Columbia Initiatives Provincial Drug Shortages Web Page:

www.gov.bc.ca/pharmacaredrugshortage Publicly available Reported and confirmed BC-specific drug shortages Temporary PharmaCare coverage of alternatives Current and resolved shortages

Updated each business day Searchable and sortable

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MELPHALAN Case Study #1

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Melphalan Nitrogen mustard-derivative alkylating agent Bone marrow transplantation Sole supplier in Canada (Aspri Pharma)

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Melphalan Timeframes for shortage Scope Key steps: local, P/T Task Team, Health

Canada Health Canada Special Access Programme

eligibility Action and resolution/outcome Lessons learned

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CLOBAZAM Case Study #2

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Clobazam 1,5-benzodiazepine with a long duration of

action Seizure disorders Generic and brand suppliers (Apotex, Teva, Pro

Doc, Lundbeck) Apotex has majority of market share

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Clobazam Timeframes for shortage Scope Multi-stakeholder engagement Key steps: local, P/T Task Team, Health

Canada Action and resolution/outcome Lessons learned

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DISCUSSION AND QUESTIONS

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Elaine Chong, PharmD, BCPS Previous Chair, Provincial/Territorial Drug Shortages Task Team Director, Decision Support and Evaluation Guidance Drug Intelligence and Optimization Medical Beneficiary and Pharmaceutical Services Division British Columbia Ministry of Health

elaine.chong@gov.bc.ca

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