Managing drug shortages during a pandemic: tocilizumab and COVID-19

The COVID-19 pandemic has revealed weaknesses in global manufacturing and distribution of medications, exacerbating many pre-existing limitations and inequities in drug supply and creating new shortages. Supply chains have been disrupted as many were designed for "just-in-time" management...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2021-05, Vol.193 (21), p.E771-E776
Main Authors: Verma, Amol A., MD MPhil, Pai, Menaka, MSc MD, Saha, Sudipta, SM, Bean, Sally, JD MA, Fralick, Michael, MD PhD, Gibson, Jennifer L., PhD, Greenberg, Rebecca A., RN PhD, Kwan, Janice L., MD MPH, Lapointe-Shaw, Lauren, MD PhD, Tang, Terence, MD, Morris, Andrew M., MD SM(Epi), Razak, Fahad, MD MSc
Format: Article
Language:English
Subjects:
Analysis
Canada
Clinical trials
Coronaviruses
COVID-19
Drug dosages
Drug stores
Economic aspects
Epidemics
Estimates
Ethics
Health care rationing
Hospitals
Immunosuppressive agents
Internal Medicine
Manufacturing
Methods
Monoclonal antibodies
Mortality
Oxygen therapy
Pandemics
Patient admissions
Physicians
Proteins
Severe acute respiratory syndrome coronavirus 2
Shortages
Statistics
Ventilators
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Summary:The COVID-19 pandemic has revealed weaknesses in global manufacturing and distribution of medications, exacerbating many pre-existing limitations and inequities in drug supply and creating new shortages. Supply chains have been disrupted as many were designed for "just-in-time" management of drug inventory to reduce the costs of storage and reduce the risk of drug expiration. The pandemic has also led to vastly increased demand for certain medications, including the highly publicized drug hydroxychloroquine, which proved to be ineffective in the treatment of COVID-19, and adjunctive medications required for the care of critically ill patients such as sedatives and analgesics. The problem of mismatched supply and demand can be exacerbated by people and institutions hoarding drugs in times of supply uncertainty. The emergence of SARS-CoV-2 prompted testing of many newly developed or existing repurposed therapies as treatments for COVID-19. Expecting drug manufacturers to increase the supply of all candidate therapies or health care providers to stockpile inventory before drugs are proven effective would be unreasonable.
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.210531