A national shortage of the breast cancer drug Tamoxifen remains ongoing, but manufacturers expect a solution in the coming months.
Dr. Leta Forbes, a medical oncologist and provincial head of the systemic treatment program for Cancer Care Ontario, said the drug remains available — there’s just less of it.
“When a patient goes to a pharmacy now, they may not be able to obtain all of their supply. They may only get 30 days at a time,” she told Global News Morning in Toronto on Friday.
She recommends that those concerned about obtaining the drug visit their pharmacy early, because some are co-coordinating with other pharmacies to share supply.
“And if you’re unable to obtain the drug, call your physician, because we can talk to you about what happens if you interrupt your therapy and what your alternatives might be,” she said.
Tamoxifen is used to treat “hormone responsive” forms of breast cancer, according to a drug fact sheet. The medication prevents the growth of cancers that require estrogen to grow by blocking the effects of the hormone.
Forbes said Tamoxifen is used to prevent the recurrence of breast cancer in patients who’ve already had their cancer removed, some for many years later.
“We also use it in patients to prevent more widespread disease to prevent the progression of their cancer,” she said.
The shortage is related to issues at the manufacturing level, drug companies say.
Three manufacturers have a version of the drug on the market in Canada: Teva Canada Ltd. (Teva-Tamoxifen), Apotex Inc. (Apo-Tamox) and AstraZeneca Canada Inc. (Nolvadex-D).
In a statement, Teva said it’s “working diligently” to meet the demand caused by a supply disruption originating with the main manufacturer and supplier of Tamoxifen in Canada.
“Teva Canada understands the urgency of covering the increased demand for this important medicine, however we must always ensure that the medicines we provide meet our rigorous quality standards, and our quality standards cannot be sacrificed for speed. During this temporary shortage, alternative medications may be available for some patients, and we encourage patients to discuss these options with their healthcare provider.”
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According to Canada’s drug shortages database, Apotex is also experiencing a manufacturing issue, while AstraZeneca is reporting shortages due to the uptick in demand, presumably related to the decrease in supply from the other drug companies.
Health Canada said it’s working with the companies involved as well as the provinces and health care professionals to share information and find ways to mitigate the issue.
“The health and safety of Canadians is our top priority, and we recognize the significant impact that this shortage has on patients,” a spokesperson for the agency said in an email to Global News.
The agency said that as a result of such work, one of the manufacturers, Apotex, has been able to decrease the length of the expected shortage. It was expected to last until the end of January, but Apotex says the anticipated end date is now New Year’s Eve.
The other manufacturers say their shortages are expected to be resolved by Jan. 31, according to drugshortagescanada.ca, a third-party website run under contract from Health Canada.
As of March 2017, legislation requires drug manufacturers to report drug shortages, current or anticipated, to the database at least six months ahead of time, or within five days of learning about it.
Health Canada must also be notified if a drug is discontinued in Canada.
In July, the Canadian Pharmacists Association released a survey of more than 1,700 of its members on drug shortages and recalls.
The vast majority — 80 per cent — said that shortages have increased greatly in the last five years.
“Drug shortages have become a time-consuming and unwelcome part of pharmacists’ daily practice, as they spend more and more of their time helping to mitigate the impact on their patients,” the organization said in a news release.
–With files from Maham Abedi, Global News