Chemotherapy shortage sparks small number of Alberta treatment delays

A drug shortage, causing worry for some Alberta ovarian cancer patients, appears to be resolving.

According to Alberta Health Services, 14 patients had their treatment delayed last week due to a shortage of a chemotherapy drug, liposomal doxorubicin.

It's used to treat several cancers, including gynecological and breast cancer, and is often a key treatment for recurrent ovarian cancer.

"There is a nationwide shortage of a specialized cancer drug that is impacting care of a small number of patients in Alberta," AHS spokesperson Kerry Williamson said in a statement shared with CBC News.

"Since December 2022, AHS has monitored and managed this shortage by moving inventory within the province and making the best use of the supply they have."

Worry for patients

"It's always scary for patients, for their families, for their providers, when you don't have access to a medication easily," said Dr. Rachelle Findley, a gynecologic oncologist and director of communications with the Society of Gynecologic Oncology of Canada.

"Every centre across Canada would have looked at any potential patient that would have been impacted and assessed to say, 'Do you need that medication right now, can it be stopped, does it need to be switched or is it just a time to take a break from chemotherapy,' which sometimes is the best option for everybody."

The shortage, she said, appears to be resolving.

"Thankfully, we do have other agents in our toolbox. So for the vast majority of patients, we can easily switch them onto a different regimen that will probably not have a significant impact on their treatment course," said Findley.

"This particular shortage was quite short. And many centres [across Canada] actually had sufficient supply. So the number of actual treatments that would have been impacted are quite minimal."

According to AHS, the 14 Alberta patients delayed last week resumed to treatment this week along with all other scheduled patients.

"Fortunately, AHS received 200 vials of the drug [Tuesday], which should provide sufficient coverage for existing patients in the short-term," said Williamson, who noted that shipment is enough to cover patient treatments this week and next.

Supplies are expected to return to normal by the end of the month, he said.

The manufacturer, Taro Pharmaceuticals, did not respond to inquiries from CBC News. 

It cited manufacturing disruptions as the cause in its report to the Drug Shortages Canada database. And, on Thursday, it updated its shortage status to "resolved."

Baxter, the company that produces Caelyx, the brand name version of the product, is not reporting a shortage.

"The pandemic has caused temporary disruptions in the global supplies of a number of products over the past two years.… AHS has been able to minimize the impacts by sharing supplies across the province, but we can't avoid them entirely," said Williamson.

"Cancer patients with questions about their treatment are asked to speak directly with their oncologist."

Meanwhile, Teva Canada is reporting a shortage of doxorubicin hydrochloride.

According to Findley, who also has a background in pharmacy, it's an older drug used to treat other cancers, including endometrial cancer.

Health Canada said it is watching the supply of these cancer drugs closely and noted it has not received "any signals or concerns of supply constraints at the national level."

"Health Canada works very closely with the Canadian Association of Provincial Cancer Agencies and has been in regular communication to identify and help mitigate and address shortages of oncology drugs," a spokesperson said in a statement emailed to CBC News.

"[We continue]  to monitor the supply of these drugs and will not hesitate to take action, in collaboration with provinces, territories and stakeholders across the supply chain to mitigate impact on patients and the health-care system."