Drug shortages

 

Current Drug Shortages (.xls)

The Current Drug Shortages list provides details about drugs covered by PharmaCare that are in short supply at B.C. community pharmacies. It includes coverage options and alternative drugs that PharmaCare is covering during the shortage. The list does not include drugs used in hospitals. The Resolved Drug Shortages list provides details about drug shortages that have ended, including when the shortage resolved and how the shortage was mitigated.

Active advisories​

Calcitriol injection USP 1 mcg/mL

• Shortage: Calcitriol injection USP 1 mcg/mL solution (DIN: 02399334)
• Mitigation: US supply imported. Use PIN 09858344 for processing
• Effective date: July 15, 2024
• Reason: Delay in shipping
• Expected resolution: Unknown
• Notes: US-supply calcitriol is a PharmaCare non-benefit, as with original Canadian product

Carbamazepine CR tablets

• Shortage: Carbamazepine CR tablets
• Mitigation: Option to use US-labelled carbamazepine extended-release tables from Septa Pharmaceuticals
  • Use PIN 09858341 for 200 mg tablets
  • Use PIN 09858342 for 400 mg tablets
• Effective date: June 11, 2024
• Notes: The US products have the same active ingredient, strengths, dosage form (expressed as "extended release tablets" instead of "controlled release" tablets), and route of administration as the Canadian products. However, US products have a different formulation and its bioequivalence to the Canadian products has not been confirmed. These products have English only labels, with a different physical appearance and non-medicinal ingredients. Carbamazepine has a narrow therapeutic index and interchanging between non-bioequivalent products that have a narrow therapeutic index may result in patients being exposed to minor variations in drug concentrations, which may affect the effectiveness or safety of the drug. Enhanced monitoring for the imported drug for the intended disease condition is recommended. Refer to Importation of USA-authorized carbamazepine extended-release tablets for details
• Ordering: Some product may be at select distributors in B.C. Direct order available from Septa Pharmaceuticals. For inquiries contact orders@septapharma.com or 1-905-564-5665
• Reason: Sandoz shortage is due to manufacturing disruptions, and Novartis shortage is due to increased demand as result of Sandoz shortage
• Resources:
  • Canadian Pharmacists Association: Managing current drug shortages
  • Canadian League Against Epilepsy and Canadian Pharmacists Association – joint communication letter
  • Health Canada supply notice: Carbamazepine controlled release tablets

Cholestyramine and colesevelam

• Mitigation:
  • US-labelled colesevelam tablets from Glenmark Pharmaceuticals have been temporarily added as a PharmaCare regular benefit - use PIN 09858334
  • US-labelled cholestyramine for oral suspension sachets from Juno Pharmaceuticals has been temporarily added as a PharmaCare regular benefit - use PIN 09858335
• Effective date: April 11, 2024 for colesevelam tablets and May 17, 2024 for cholestyramine sachets
• Notes:
  • The US-labelled colesevelam has the same active ingredient, strength, dosage form, route of administration, product formulation, indications, dosage, and administration instructions as the Canadian-authorized products. The products differ in the non-medicinal ingredients, tablet markings, and storage conditions. The US-labelled product has English only labels. Refer to: FDA Label for Colesevelam Hydrochloride Tablet
  • The US-labelled cholestyramine has the same active ingredient, strength, dosage form, and route of administration as the Canadian-marketed products. The products differ in the non-medicinal ingredients, appearance, inner and outer labels, and packaging. The US product is a pale yellow to yellow powder with orange flavour and may taste or appear different than Canadian-marketed products due to the differences in non-medicinal ingredients. There are also differences in the approved indications; however, the US product can be used for the same indications as the Canadian-marketed products. The US-labelled product has English only labels
• Resources: 
  • A supply notice is posted on Health Canada’s website
  • Healthcare providers can access resources to help manage this shortage from the Canadian Pharmacists Association and the Canadian Association of Gastroenterology: Managing current drug shortages - Cholestyramine/Colestipol and Cholestyramine Shortage (PDF, 163KB)

Prazosin tablets

• Shortage: Prazosin tablets
• Mitigation: SteriMax’s US-authorized prazosin capsules have been temporarily added as a regular PharmaCare benefit
  • PIN 09858281 1 mg US-labelled prazosin capsule
  • PIN 09858282 2 mg US-labelled prazosin capsule
  • PIN 09858283 5 mg US-labelled prazosin capsule 
• Effective date: October 4, 2023
• Notes: Consult the SteriMax document for more information: Importation of US-labelled Prazosin Hydrochloride Capsules (PDF, 508KB)

Apomorphine injection and sublingual film

• Shortage: Apomorphine injection and sublingual film
• Mitigation: Use UK-labelled APO-go PEN (apomorphine injection) 30 mg/3 mL using PIN 66128457. Note that APO-go PEN is not an eligible PharmaCare benefit
• Notes:
  • UK-labelled apomorphine may be imported until December 31, 2024
  • Patients are encouraged to discuss options with their healthcare providers and transition off product, as there is uncertainty with the availability of apomorphine
• Reason: Kynmobi (sublingual film) and Movapo (injection) have been discontinued in Canada
• Resolution: There is no anticipated resolution. Canadian products have been discontinued, and the UK-labelled product importation is a temporary measure

Collagenase (Santyl^®) ointment

• Update: US supply of collagenase (Santyl^®) ointment has been imported into Canada and is available for order through McKesson Canada. Note that the US supply is now a regular PharmaCare benefit. Use PIN 066128469 to enter prescriptions into PharmaNet
• Effective date: April 25, 2024. Updated March 6, 2025
• Resources:
  • Health Canada's List of drugs for exceptional importation and sale
• Resolution: Intermittent US supply has been imported. Resolution is expected in 2026

Glucagon for injection

• Effective date: October 6, 2023
• Shortage: Glucagon for injection
• Mitigation: Use US-labelled glucagon from Amphastar Pharmaceuticals using PIN 09858279 
• Notes:
  • US labelled glucagon is limited coverage
    • Special Authority details: Limited coverage drugs - glucagon
    • Criteria: for the treatment of severe hypoglycemia in patients who the nasal spray dosage is not appropriate
  • Amphastar's glucagon for injection is NOT considered equivalent to Eli Lilly's Canadian marked glucagon (DIN 02243297). Please follow the US labelling when using Amphastar's glucagon, since there is no equivalent Canadian Labelling available
  • Baqsimi, a nasal formulation of glucagon, is available and is a regular PharmaCare benefit

Coverage for alternative drugs

PharmaCare may cover an alternative drug during a shortage. Coverage for the alternative drug is often the same as for the drug that is in short supply (e.g., the plan it is covered under and whether it needs Special Authority approval for coverage). To look up PharmaCare coverage of a specific drug, use the Formulary Search.

Sometimes the alternative is a foreign-labelled product. If this is the case, PharmaCare assigns the product a PIN, as it will not have a DIN.

For details on submitting a foreign-labelled product visit Foreign-authorized drug submissions.

PharmaCare may cover a compounded drug as the alternative drug on a last-resort basis.

When a shortage ends, the information is removed from the Current Drug Shortages list and is added to the Resolved Drug Shortages list, and any alternative product returns to its former benefit status.

PharmaCare often covers several versions of a drug. If one supplier’s version runs short, prescribers and pharmacists can consult the Low Cost Alternative program listings to learn whether another version is covered.

If PharmaCare is not covering an alternative drug

If there is no covered alternative drug, patients and their health care providers may need to discuss different treatment options.

Reasons for drug shortages

A drug shortage happens when a drug manufacturer or distributor cannot supply enough of a drug to meet demand. It can result from various supply and demand issues, including manufacturing delays, distribution issues (including importation) and product discontinuations.

Shortages happen fairly regularly. Most drug shortages are temporary, but permanent shortages may occur when a drug is discontinued. 

​Resolved Drug Shortages (.xls)