This weekend, we have an encore presentation of our debut show on Drug Shortages. It's our first opportunity to replay the show since it first aired on Monday, September 3.  You can listen to the show again by clicking on the audio link.  We have also posted lots of bonus material including audio as well as links to some of the best web sites on drug shortages in Canada.  Please note that the weekly podcast is our episode Wandering (Dementia) which first aired on WCBA on Saturday, February 19, 2011.  The Wandering show is a close and personal look at dementia and people who wander from home and hospital.

Since our show on drug shortages first aired last month, a number of things have come to our attention that are worth passing on.

One thing we touched on but did not explore is the role Canada's increasing dependence on one or two drug companies plays in the drug shortage situation.  One web site that has looked at this issue is Healthy Debate.  The web site takes an unbiased and sometimes jaundiced look at important issues in health care in Canada these days.  It's well worth reading.

In a post dated April 19 2012, authors Irfan Dhalla, Karen Born and Jeremy Petch go past the federal-provincial blame game and look at what they see as the origins of single source suppliers of generic drugs in short supply.  The authors focus on the role played by group purchasing organizations (GPOs). They include Medbuy and HealthPRO.  In their blog post, the authors say that GPOs supply drugs to hospitals and other facilities and were established to increase efficiency for hospitals by enabling them to negotiate with the GPO instead of having to source drugs from multiple pharmaceutical companies.

The upside - say the authors - is that "GPOs drive down prices by buying in bulk. But the downside of negotiating aggressively is that sometimes only one manufacturer remains willing to supply a particular drug at the negotiated price."

The article quotes Richard Jones, a Vice-President at Medbuy as saying "GPOs are complying with the procurement policies of governments - to reduce costs to the public purse.  However, neither governments nor GPOs can control the business decisions of corporations affecting the public offerings they make available in Canada.  One unintended consequence is that the marketplace can be left with a single supplier for a key product leaving Canadians vulnerable to any production related issues."

The authors sourced a 2008 Report by the Competition Bureau that recommended that GPOs be compelled to select two or more suppliers of drugs and that penalty provisions be adopted. They note that while penalties have been put in place, GPOs are still not compelled to select more than one supplier.  Other countries put the onus on GPOs to select more than one supplier.

A big thank you goes to healthydebate.ca for providing this analysis.

To me, this is yet another example of the sometimes opaque and often hard to comprehend business practices involved in providing essential prescription drugs to Canadians.  The business arguments are important.  But let's not lose sight of the personal and professional cost of drug shortages.  As we told you on WCBA, patients are being harmed, surgeries are being postponed, and doctors are resorting to second class treatment.

The role GPOs play in the drug shortage story is another reason why I'm calling for a full public inquiry to look into scope of the drug shortage problem, the causes, and to propose solutions.

One thing that isn't news is the Canadian Drug Shortage Database, which I referred to in the program and on our web site.  It's an industry sponsored database that attempts to keep track of prescription drugs on back order.  For some reason, late last month, some media outlets reported the web site as new.