Should Canada produce more medicine amid ongoing shortages?

As Canada faces an ongoing shortage of children’s medications, Prime Minister Justin Trudeau says he doesn’t know if ramping up domestic production of pharmaceuticals is the right approach to addressing the problem.

“I don’t know offhand if it is the right thing for Canada to be starting producing these particular pills or whether it’s just a question of getting more reliable supply chains and agreements out there,” Trudeau said last week in an interview with The Canadian Press.

Canada has been experiencing a nationwide shortage of children’s pain medications for months, leaving parents scrambling to manage their children’s fever and pain as rates of respiratory syncytial virus and influenza skyrocket.

The drug shortage has led to some calls for Canada to invest more in its pharmaceutical production capacities for essential medications.

However, Trudeau said that might not be the best use of taxpayer dollars.

“If we had a big orange shortage in Canada, people might be shouting, ‘Okay, we need to make them more greenhouses so we can grow more oranges in Canada,'” the prime minister said.

“That might not be the best way to spend our money.”

Trudeau said he’s focused on solving the problem of drug shortages using the most efficient approach, even if that means sourcing medications from other places in the world.

Apples-to-oranges comparison ‘terrible analogy’

The example Trudeau used to illustrate the difference between importing and producing domestically was too much of an apples-to-oranges comparison for the NDP’s health critic Don Davies.

“To compare oranges to essential medication that people may need to stay alive … that’s a terrible analogy,” he said.

Davies said Canada needs a national strategy for pharmaceuticals that would both promote a strong private sector and include a publicly owned manufacturer. “Do we want to be vulnerable to the vagaries and vulnerabilities of global supply chains and decisions made by the private sector?”

For medications that are in short supply, the federal government has been relying on imports. Health Canada has brought in nearly 1.9 million bottles of foreign products and “more is coming,” a spokeswoman said on Tuesday.

She said the federal department is “using all tools at its disposal to help alleviate the shortage” of pain medications and “proactively working with companies to facilitate the importation of foreign products.”

But pharmacists have warned that the emergency imports may not be enough.

“Most of the pharmacies are doing purchase limits, one quantity per person, keeping it behind the counter, telling people to buy only what they need,” Shelita Dattani, vice president of pharmacy affairs for the Neighbourhood Pharmacy Association of Canada, said last month.

‘Problematic’ dependence on sources outside Canada’s borders

Canada’s experience with the pandemic and vaccine procurement has raised questions about how much the country should rely on global supply chains for essential goods.

Jillian Kohler, a professor at the University of Toronto’s Leslie Dan Faculty of Pharmacy, said governments need to be much more engaged when it comes to ensuring reliable supplies of pharmaceutical products.

She said the shortage of children’s pain medication speaks to the country’s “very problematic” dependence on sources outside Canada’s borders and on the private sector.

“We need to think of health products as health security, as something that’s a national-security issue,” she said. “And relying on the private sector, whether it’s domestic or external to Canada, is risky.”

Davies said creating a public manufacturer of pharmaceutical products wouldn’t be an entirely new idea. The federal government used to own Connaught Laboratories, which developed and produced vaccines as well as insulin. The laboratory was sold off to the private sector in the 1980s.

However, Christopher Rutty, an adjunct professor at the University of Toronto’s Dalla Lana School of Public Health, said in an email that the lab was not focused on the development and production of chemically-derived pharmaceuticals such as pain medication.

Kohler said public manufacturing has not been historically viewed as a cost-effective approach of producing medications. She said it’s time for a shift in thinking.

“Governments have a responsibility for the health of their populations. And old models don’t work, as we’ve seen. So we need to rethink: how do we ensure security for our population’s health needs?”