Drug supply chain disruptions led to significant shortages in the United States more often than in Canada from 2017 to 2021, a study today in JAMA suggests.
A University of Toronto–led research team used the IQVIA Multinational Integrated Data Analysis database to identify drug supply chain problems and shortages less than 6 months apart in the United States and Canada from 2017 to 2021. The IQVIA database contains information on 89% of US and 100% of Canadian drug purchases.
A shortage was defined as a decrease of at least 33% in monthly purchased standardized drug units within 1 year, relative to those in the 6 months before the report of supply chain issues to a US or Canadian reporting system.
International cooperation needed
A total of 104 drug supply chain issues occurred in both countries, and within 1 year, 49.0% (95% confidence interval [CI], 39.3% to 59.7%) were tied to significant drug shortages in the United States, compared with 34.0% (95% CI, 25.0% to 45.0%) in Canada (adjusted hazard ratio [aHR], 0.53; 95% CI, 0.36 to 0.79).
These findings inform ongoing policy development and highlight the need for international cooperation between countries to curb the effects of drug shortages and improve the resiliency of the supply chain for drugs.
The lower risk of drug shortages in Canada compared with the United States was consistent before (aHR, 0.47; 95% CI, 0.30 to 0.75) and after the COVID-19 pandemic (aHR, 0.31; 95% CI, 0.15 to 0.66). Combining reports of supply chain disruptions in both countries revealed that the shortage risk was double for sole-source drugs (adjusted HR, 2.58; 95% CI, 1.57 to 4.24) and nearly half for Canadian tier 3 drugs (adjusted HR, 0.56; 95% CI, 0.32 to 0.98).
"Drug-related reports of supply chain issues were 40% less likely to result in meaningful drug shortages in Canada compared with the US," the study authors wrote. "These findings inform ongoing policy development and highlight the need for international cooperation between countries to curb the effects of drug shortages and improve the resiliency of the supply chain for drugs."