Question Period Note: COVID-19 CRITICAL DRUG RESERVE

• COVID-19 created an increased demand for drugs used in supporting patients with the disease, against the backdrop of multiple global supply chain challenges. Drug shortages, particularly in the context of COVID-19 critical drugs, could put the health of Canadians at risk.

• Working with provinces, territories and other partners, Health Canada established a COVID-19 Critical Drug Reserve, which consists of up to a six-month supply of drugs used to support patients with COVID-19.

KEY MESSAGES

• The Government of Canada has taken numerous proactive measures to help mitigate the risk of drug shortages and protect the health and safety of Canadians.

• Working with provinces and territories and other partners, Health Canada established the COVID-19 Critical Drug Reserve in 2020.

• This Reserve complements other federal, provincial and territorial drug shortage management efforts, and functions as a safety net by augmenting the supply of key drugs used in treating patients with COVID-19 in Canada.
IF PRESSED ON WHAT DRUGS HEALTH CANADA PURCHASED FOR THE CRITICAL DRUG RESERVE …

• Based on Canada’s experience to date, analyses, discussions with provinces and territories, as well as the advice of health care experts, the Critical Drug Reserve holds twelve drugs used in hospitals to support patients with COVID-19, including sedatives, pain relievers, antibiotics, and neuromuscular blockers.
IF PRESSED ON PARTICIPATION …

• The Critical Drug Reserve functions as an additional safety net in the event of shortages of these key drugs used in the treatment of COVID-19 symptoms, and complements the provinces’ and territories’ current drug shortage mitigation measures.

• Participation in the Critical Drug Reserve is voluntary, with most provinces and territories.
IF PRESSED ON JURISDICTION …

• The Government of Canada’s top priority is protecting the health and safety of Canadians, a goal shared by all provincial and territorial governments.

• Working with the provinces and territories and other key partners, the Critical Drug Reserve was established as a safety net that increases existing drug supply and builds on current drug shortage mitigation efforts.

• The federal government’s leadership has enabled the Critical Drug Reserve to be established as an additional tool in our collective pandemic response efforts.
IF PRESSED ON STATUS OF DRUG PROCUREMENT …

• Canada has purchased all the drugs to meet the shared PT supply targets for the Critical Drug Reserve.
IF PRESSED ON COST …

• To date, the Government of Canada has awarded close to $30 million in contracts for drugs in the Critical Drug Reserve through competitive processes that are cost-shared with participating provinces and territories.

• Drug pricing is influenced by a number of factors, including availability, supply chain constraints, global import/export restrictions, and competition in the global marketplace.

• As with all purchasing, value for money was a key consideration.
IF PRESSED ON THE CRITICAL DRUG RESERVE’S END DATE …

• The Critical Drug Reserve was established as a back-stop for a limited period of time and is set to end on March 31, 2022.

• The supply of drugs contained in the Critical Drug Reserve is stable. If this changes, the Government will re-assess the situation.

Health Canada’s role

Health Canada works with provinces and territories and stakeholders across the drug supply chain to identify mitigation strategies, which includes regulatory measures and/or exploring access to alternative products available in other jurisdictions. Creating a reserve for drugs critical to the treatment of COVID-19 symptoms is one such strategy.

During the first wave of the pandemic, shortages were identified for key drugs used in treating patients with COVID-19. The Critical Drug Reserve serves as a backstop for Canada’s existing supply, complements the current drug shortage management systems, and will help prevent critical drug shortages, which will in turn, help to relieve pressures on provincial and territorial health care systems.

Factors that were considered in the pursuit of a critical drug reserve included whether the drug is important for the treatment of COVID-19 symptoms, whether the drug either is in shortage or is likely to be in shortage, and whether alternative or substitute drugs are available. The following drugs are in the Critical Drug Reserve:

• Cisatracurium (Neuromuscular blocker);
• Epinephrine (Adrenergic agonists);
• Fentanyl (Opioid analgesic);
• Norepinephrine (Adrenergic agonists);
• Propofol (Sedative);
• Rocuronium (Neuromuscular blocker);
• Salbutamol (Bronchodilator);
• Ceftriaxone (antibiotic);
• Dexamethasone (corticosteroid);
• Hydromorphone (analgesic);
• Midazolam (sedative); and
• Vasopressin (vasopressor).

Engagement with Provinces and Territories

To address drug supply issues, Health Canada has strengthened existing mechanisms for managing drug shortages, and has leveraged existing FPT infrastructure and increased cooperation with multiple partners to identify shortage signals earlier, particularly for critical drugs required for COVID-19. This increased collaboration and coordination is reflected in the efforts made by Health Canada and the provinces and territories to create the reserve.

Given the need for close cooperation on the shortage of critical drugs, a Framework for the Effective Management of Drug supply in the Context of the COVID-19 Pandemic has been developed and agreed to by provinces, territories and the federal government. This Framework sets out the common principles for managing drug shortages and guiding decisions in the context of the COVID-19 pandemic. Principles include solidarity, fairness, openness and transparency and FPT collaboration. These principles have been implemented through the federal government facilitating access to alternative drug supplies to prevent shortages, and building the Critical Drug Reserve to support patients with COVID-19.

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