Study: Supply Chain Issues Less Likely to Result in Drug Shortages in Canada Compared to United States

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A new study published in JAMA Original Investigation found that drug-related reports of supply chain issues in Canada were less likely to result in significant drug shortages compared to the United States. According to the authors of the study, the results suggest that Canada may have a more resilient drug supply chain or different thresholds for reporting and responding to supply chain issues.

To find the most accurate number, the study researchers conducted a longitudinal cross-sectional analysis from January 2023 to March 2024. As part of the study, data from the IQVIA Multinational Integrated Data Analysis database were utilized. These data included a significant portion of drug purchases in both countries. The primary endpoint of the study was to determine how frequently reports of supply chain issues were associated with meaningful drug shortages, defined as a decrease of 33% or more in monthly purchased standardized drug units within 12 months of the report.

“Our US drug supply chain is linked globally—shortages in one country can happen in another country—presenting an opportunity to compare and contrast how different countries are affected,” said Katie J. Suda, PharmD, MS, corresponding author, in a press release.²

Results found that in Canada, supply chain issues were 40% less likely to result in significant drug shortages. In total, 104 drug-related supply chain issues were identified during this period. In the United States, 49% of the reported supply chain issues were associated with meaningful drug shortages within 12 months. In contrast, only 34% of similar reports in Canada led to drug shortages during the same timeframe. The analysis considered drug formulation, the number of manufacturers, and the availability of therapeutic alternatives, which could influence the risk of shortages.¹

According to the authors, there were a notable number of strengths of the study. This included a comprehensive dataset, which captured a large proportion of drug purchases and provided a robust basis for analysis. Further, its longitudinal design enabled a detailed examination of trends over time, particularly in the context of the COVID-19 pandemic, which has produced significant challenges to supply chains. Further, the authors stated that the study's focus on a direct comparison between two countries can inform policy development and strategies to improve drug availability.

Despite these strengths, the authors also noted that were a few limitations to the study as well. The dataset, which was concluded in 2021, had a limited timeframe. As a result, it restricts the ability to assess the long-term effects of pandemic-related policies on drug shortages. Additionally, the database didn’t include data on OTC drugs. Other limitations included a heavy focus on supply-driven shortages compared to demand-driven factors, different reporting thresholds in both countries, and possible unmeasured factors influencing drug shortages that were not accounted for in the analysis.¹

“The US can learn from other countries’ pharmaceutical policy to mitigate the impact of shortages on access to essential medications. We also need to cooperate locally and globally to strengthen our pharmaceutical supply chain and regionally to recognize the interconnectedness of supply chains essential for North American health security,” said Suda, in the press release.²

References

1. Differences in Drug Shortages in the US and Canada. JAMA. October 31, 2024. Accessed November 4, 2024. https://jamanetwork.com/journals/jama/fullarticle/2825535?guestAccessKey=45d5ebdb-f880-4f40-8e06-3719a132643d&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=103124#google_vignette

2. Differences in Drug Shortages in the US and Canada. EurekAlert! October 31, 2024. Accessed November 4, 2024. https://www.eurekalert.org/news-releases/1063088