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Managing current drug shortages

At any given time, there are between 1500 and 2000 active drug shortages in Canada. In many of these cases, pharmacists play an important and effective role in managing shortages at the pharmacy level. Below you will find information and resources related to several current shortages that may have a widespread impact on patients and pharmacies. 

Our role: CPhA works closely with Health Canada and others to represent the pharmacy profession. This includes advocating on pharmacists’ behalf, communicating shortage updates and recommendations, collecting frontline data to help inform allocation and procurement strategies, and developing tools and resources to support pharmacy and patients.

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Peginterferon alfa-2a (Pegasys) 

There is a critical shortage of Pegasys (peginterferon alfa-2a) injection in Canada. Given the serious risks this shortage presents to patients in Canada who have been prescribed interferon-based therapy for treating myeloproliferative neoplasms (MPNs), Health Canada has permitted the exceptional, temporary importation and sale of a similar but not identical product, US-authorized BESREMi (ropeginterferon alfa-2b-njft) injection with English-only labels by FORUS Therapeutics Inc. The shortage is expected to last until the end of December 2025.  To support, your patients during this shortage:

  1. Do not initiate new patients on Pegasys.
  2. Do not order or dispense large quantities of Pegasys.
  3. For patients MPNs, consider alternative medication as per guidance from the Canadian MPN Network: Guidance on transition is available here.
  4. Cutaneous T-cell lymphoma (CTCL) patients and pregnant patients should not be switched to Besremi. Pegasys remains the preferred interferon in this population as per guidance from the Canadian MPN Network.
  5. If a patient cannot be switched to Besremi, it is crucial to optimize dosing by using the lowest effective dose as per the Canadian MPN network.
  6. Please note that there are differences in the Besremi and Pegasys syringe format. Besremi is only available in a single dose pre-filled syringe with a manual safety needle cap. Counselling patients when converting patients will be required.

Further information about the shortage and guidance for health-care professionals can be found below.

Information and resources

Hypurin (porcine insulin) discontinuation

Wockhardt UK, the only current, global supplier of porcine insulin has informed Health Canada that it will no longer supply porcine insulin products for the Canadian market. Health Canada is working with the importer to monitor the remaining supply and is exploring ways to extend the availability of animal-sourced insulin by importing a UK-authorized supply that expires May 2026. No additional inventory of these drugs will be available after this inventory has been depleted. See Health Canada’s supply notice for more information.

Information and resources

CPhA, the Canadian Society of Healthcare-Systems Pharmacy (CSHP) and the Canadian Society of Endocrinology and Metabolism (CESM) have developed the following resource to help support pharmacists and other health-care providers manage the discontinuation.

Baqsimi

Amphastar is reporting a shortage of Baqsimi (nasal glucagon powder) due to a change in the packaging site. The shortage is estimated to end by February 27, 2025. Health Canada is working with stakeholders, including the manufacturer, Diabetes Canada and the Canadian Society of Endocrinology and Metabolism (CSEM) to monitor the supply situation.

Information and resources

Diabetes Canada and CSEM have published a notice with more information, including care recommendations for people living with diabetes.

Salbutamol

There are currently reported shortages of salbutamol metered-dose inhalers (MDIs) and nebules due to manufacturing disruptions and demand increases.

Supply issues impacting nebules have resulted in demand increases for MDIs as patients are switched from nebules. Manufacturers are managing available inventories and supplies of both nebules and MDIs are expected to be constrained until spring 2025.

On January 17, 2025, a Tier 3 status was assigned to the salbutamol shortage. Health Canada is in contact with manufacturers and is closely monitoring the supply situation. See Health Canada’s supply notice for more information.

Information and resources

CPhA and medSask have developed the following clinical resource to support pharmacists as they help their patients navigate this shortage and available alternatives.

Lithium carbonate

Canada has been experiencing shortages of lithium carbonate since summer 2024, predominantly impacting 300mg oral lithium products. A tier 3 shortage was declared on July 25, 2024. Health Canada continues to closely monitor the supply situation.

Information and resources

CPhA has developed the following clinical resource to support pharmacists as they help their patients navigate this shortage and available alternatives.

Hormone replacement therapy

There are ongoing supply challenges impacting estrogen transdermal patches and vaginal rings (Estring) in Canada. Health Canada is in contact with manufacturers and is closely monitoring the supply situation. While there is not a clear resolution timeline in place for these shortages, there is currently an adequate supply of alternative products, including transdermal gels, vaginal creams and tablets to compensate for these shortages.

Information and resources 

CPhA has developed the following clinical resources to support pharmacists as they help their patients navigate this shortage and available alternatives. 

Tamsulosin 

On January 26, 2024, a Tier 3 status was assigned to tamsulosin. Tamsulosin hydrochloride oral tablets are marketed by 8 companies in Canada, many of which reported shortages or discontinuations throughout 2024.

Information and resources

Other links and resources