Drug supply chain problems are more likely to cause shortages in the U.S. than in Canada, study finds

According to a study by researchers at the University of Pittsburgh published in , reports of drug-related supply chain problems were 40% less likely to lead to drug shortages in Canada compared to the United States JAMA.

The analysis examined drugs for which supply chain disruptions were reported in both countries between 2017 and 2021 and found that within 12 months of an initial U.S. report, nearly half of them resulted in drug shortages in the U.S., up from about one third in Canada. According to the reports, there was also a consistently lower risk of shortages in Canada in every month.

“Drug shortages cause real disruption in patients’ lives and often lead to interruption or delay in treatment,” said lead author Dr. Katie J. Suda, Pharm.D., MS, professor at Pitt School of Medicine and deputy director of the Center for Drug Policy and Prescribing.

“We can learn from other countries that are succeeding in mitigating the impact of drug shortages on patients.”

The researchers used reports on supply chain issues from the U.S. Food and Drug Administration, the American Society of Health-System Pharmacists and Health Canada. They then compared these reports to actual drug use in both countries and defined a drug shortage as a decline of at least 33% in units purchased each month compared to the average units in the six months prior to the report.

Most reports of supply chain issues were due to manufacturing or shipping issues. However, a quarter of US reports did not give a reason. In both countries, generics accounted for 95% of reports, and one-fifth of these were standalone medications.

However, the route of administration, time since approval by the Food and Drug Administration (FDA), and drug price per unit did not indicate a drug shortage.

“The pharmaceutical supply chain is global and every single person who comes into contact with a drug is critically important, from the manufacturer to the dock worker to the pharmacist,” said lead author Mina Tadrous, Pharm.D., Ph.D., assistant professor at the University of Toronto's Leslie Dan Faculty of Pharmacy.

“There will be shocks to the supply chain and it is important to work together internationally to develop strategies to minimize disruption to patients.”

While the paper does not examine the reasons for the differences in drug shortages in the two countries, the authors note that in Canada there is greater collaboration between regulators, health systems, public payers and other key players such as manufacturers and wholesalers.

Canada also uses its drug stockpiles to address drug shortages, while supplies in the U.S. are intended for acute events such as terrorism or mass casualties. The authors also said policymakers should consider incentivizing the manufacture of generic drugs with lower profit margins.