By Deron Hamel

Stakeholders would be better positioned to offer solutions to prevent medication shortages if pharmaceutical companies provided public explanations about why shortages happen, says Suzanne Nurse, Epilepsy Ontario’s director of information and client services.

Following public consultation in 2014, the Canadian government announced it would be mandating the country’s pharmaceutical manufacturers to publicly announce medication shortages. Mandatory reporting is not in place yet, but even with compulsory reporting, processes need to be in place to prevent shortages of lifesaving medications, Nurse says.

Currently, six medications manufactured by Apotex that are commonly taken by people with seizure disorders are in short supply. These are divalproex, clobazam, levetiracetam, lamotrigine, pregabalin and topiramate.

There’s no explanation for the shortages, Nurse says. Lack of active ingredients, Canadian generic medication pricing policies and global factors have been proposed by some experts as possible causes of shortages, “but it’s all just speculation unless the manufacturers come forward and explain what is going on,” she says.

Shortages of epilepsy medications are “terrifying” for people needing the drugs and their families because of the health and safety risks, Nurse says, adding this is the third time in recent years clobazam, an anti-seizure medication, has been in short supply.

If public explanations were provided when drug shortages occur, stakeholders – whether independent agencies or government organizations – could play a part by working with others, nationally and internationally, to prevent shortages or to mitigate their impact, Nurse says.

For instance, providing explanations for drug shortages would allow global health-care regulators to work together to obtain ingredients that might be in short supply in one country but not in another.

Epilepsy Ontario and other advocacy organizations could play a role by creating dialogue with drug manufacturers to underscore the impact certain medications have on people’s lives, Nurse says.

“When we don’t know what’s happening, it makes it difficult to figure out what needs to be done to prevent it,” she says.

“Knowing what the biggest factors are behind shortages would help us identify what needs to be done to try to prevent them from happening.”

Mandatory reporting will give the public notice of which medications are in short supply, but without an explanation, it’s just a drug’s name on a list, she adds.

“The impact and the personal experience is lost,” Nurse says. “One of the roles Epilepsy Ontario plays is making sure that all the stakeholders that are involved in this issue are aware of how serious (drug shortages are) and how terrifying this is for people living with epilepsy.”

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