While the province scrambles to locate alternate sources of injectable drugs to deal with a nationwide shortage, there have so far been no cancellations or postponements of surgery in B.C. hospitals.
But the effects of the temporary shutdown of Sandoz Canada's drug manufacturing plant in Quebec, the source of 90 per cent of the country's injectable medications, is being felt by Prince George pharmacists and dentists.
Jim Ewert, the owner of Hart Drug Mart, supplies narcotic pain medication to the Prince George Hospice House for palliative care patients and since Sandoz's production was interrupted he's had to find an alternate source, tapping into the supply of University Hospital of Northern B.C.
"There have been some shortages for the last couple of years and in most cases we've found another supplier, but this current situation is a single-source supplier and nobody else is making these injectables," said Ewert. "The hospital is helping us with any emergency medications required for people in pain. Pills haven't been as big of an issue because there's usually another supplier and it hasn't been critical medications like this that have been shorted. When it comes to pain control there are limited options."
The shortages became a critical issue March 4 when the Sandoz plant was hit by a fire, two weeks after the company announced it was scaling back production of about 100 medications, including antibiotics, painkillers and anesthetics, after the U.S. Food and Drug Administration found the plant was not meeting quality control standards. Sandoz is back in production but it could be 18 months before supplies are restored.
Ewert said there are ongoing concerns about the availability of some non-injectable prescription drugs. In some cases, that has forced pharmacists to switch from generic preparations to higher-priced name-brand products, and customers are not happy about it. Some of the generic eyedrop treatments for glaucoma patients are no longer available and the only alternative for Ewert is name-brand prescriptions. Hospital pharmacists are finding some generic drugs for relieving the side-effects of chemotherapy in cancer patients are in short supply or have been discontinued.
"It's odd that a lot of the companies that used to make two or three options are suddenly limiting those options now and making it difficult for us," said Ewert. "We spend a lot of time on the phone trying to source out supply.
"Dentists are calling us in desperation because they have to cancel their surgeries if they can't get supplies. They keep a good two-month supply on hand and they're just starting to realize it."
Dentists have discovered there's a run on supplies of sedatives. Halcion, a tranquilizer favoured by dentists because it has a short half-life after introduction into the body, has been hard to find.
"We've been in short supply of Halcion for months now," said Dr. Gregory Ames, a dentist with the Southridge Dental Agency. "We use antibiotics and stuff, but it's just the family of tranquilizers we've been in short supply."
Ames said he's had no trouble finding anesthetics like Novacaine, which is made in Ontario, but some injectable sedatives used for more extensive dental surgery - particularly midazolam -- are also becoming harder to find. Dr. Kerim Ozcan, the only Prince George oral surgeon/dentist who performs operations that require intravenous sedation, could not be reached for comment.
