Insights August 2013

Chemo scandal: Health Canada must act now

Lee Prokaska

In light of the report released this week on the diluted chemotherapy drug scandal, it is not good enough for Health Canada to continue "looking" at the issue. The federal agency must act quickly to take on oversight of companies that supply pre-mixed drugs to hospitals.

It is particularly critical for Health Canada to accept the oversight role because the issue of responsibility has been debated between the federal agency and the provinces since 1997. That's about 16 years of "looking" without taking action. It's well past time to just do it.

Pharmacist Jake Thiessen was commissioned by the province to review the drug supply system after it was discovered earlier this year that about 1,200 cancer patients in Ontario and New Brunswick were treated with diluted chemotherapy drugs. In the aftermath of the discovery, it quickly became clear there is a regulatory gap - Marchese Hospital Solutions, which supplied the drugs through a group-purchasing organization, operated without federal or provincial regulation because each level of government believed the other was regulating such companies.

Thiessen recommends that the regulation of all entities that mix drugs outside a licensed pharmacy should be the federal government's job because it's a "cross-border issue" given that some companies in this growing industry ship drugs across provincial and territorial boundaries.

Frankly, and with all due respect to Thiessen, this seems to be a no-brainer. Rather than playing hot potato with this issue for years, Health Canada should have been proactive in establishing regulatory control.

Beyond that, Thiessen said he found serious flaws and substantial communication gaps within the supply chain for cancer drugs. The hospitals, for example, didn't know the drug bags contained extra saline solution, so they didn't adjust doses to compensate. And the group purchaser, Thiessen found, didn't specify the drug concentration in the finished product. He also made it clear there was "no evidence of any malicious or deliberate drug-sparing dilution" by Marchese Hospital Solutions of Mississauga, a branch of Hamilton-based Marchese Health Care.

Thiessen's 12 recommendations aim to prevent similar confusion in future by establishing well-defined oversight, clear communication and increased transparency in group-purchasing contracts. Ontario Health Minister Deb Matthews says the province supports all the recommendations and will introduce some related legislation this fall.

The province's plan is a good starting point for rebuilding public trust in the drug-supply system on which cancer patients and their families rely for potentially life-saving treatment. Now it's up to Health Canada to get with the program, take responsibility and stop looking for reasons not to regulate that system.

© 2013 Torstar Corporation 


Hamilton Spectator | Fri Aug 9 2013 | Page: A12 | Section: Editorial



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