Shortages of over 1,800 medications are driving Canadians into the United States to seek over 1800 medications are on the drug shortage list in Canada, causing some Canadians to have to travel across the US border to access their essential drugs.
Angelle Ritchie, 50, is a musician living in Oshawa, Ont. She’s been living with Crohn’s Ileitis, a form of inflammatory bowel disease, since she was 18 and has had several bowel resections resulting in short bowel syndrome.
Ritchie’s condition makes her dependent on drugs like Cholestyramine, or Questran, a drug that reduces bile acid and is used to treat high cholesterol, and Lomotil, which is often used as an antidiarrheal, to function in day-to-day life.
“Without my medications, I end up in the hospital. They have to admit me, and I’m pretty much down for the count until I get those meds,” she said.
Due to a shortage of powdered Questran, Ritchie had to travel to Niagara Falls, N.Y. to access the bile acid sequestrant critical to maintaining her health.
According to Ritchie, the first time most people experience a drug shortage is when they go to the pharmacy and are told there are none available.
“What (the pharmacists) usually do is recommend that you start calling. And that’s what I was doing on my lunch breaks when the first shortage started. I would take a list, go down the list, call, and check to see if they had any,” she said.
Once a place confirms they have the drug available to patients who aren’t regular customers of that pharmacy, the prescription has to be faxed from one pharmacy to the other. Then patients have to pick it up physically with ID in hand.
“If you have mobility issues or you don’t have someone to drive you around and now you’re having to go to seven different pharmacies. Picking up four or five (doses) here or ten there or whatever they have available, it can start to get not only expensive but very time-consuming,” Ritchie said.
The first time she experienced a drug shortage was when she was living in London, Ont. in 2002. The drug that was in short supply was Lomotil, a drug she still uses today.
Lomotil is rarely used for Crohn’s disease, but she’s an “extreme case.” She found out about the shortage when preparing to travel north for her father’s funeral.
“I basically called every pharmacy from London to North Bay and picked up ten pills here and 15 there and five here and 40 there,” she said. Which soon became a regular routine.
That was before there was a website that showed what drugs were in short supply. It’s become a routine for Ritchie to check the site every week or two to see if the drugs she needs have been listed since it first emerged in 2018.
She said Lomotil is the drug she’s had the most trouble with getting over the last 20 years. But last month, both Lomotil and Questran were on the shortage list, forcing her to cross the border into the US.
“What happens is there are gaps in the supply chain. And essentially, it was up to me to start calling, and I literally called almost 20 pharmacies a day. I’ve driven up to three or 400 kilometres away,” Ritchie said.
It’s more than a hassle for Ritchie to get the drugs she needs to make her condition livable. She had to take time off work to make phone calls to locate the drugs and arrange doctor appointments in the US to get American prescriptions.
“It worked out to a one-month supply costing me 140 American dollars ($188.48 Canadian) plus the cost of the actual visit, which was close to $200 Canadian.”
She described the experience overall as both stressful and a huge relief because she’s been dealing with drug shortages “for a really, really long time.”
When she had to go to the US, she was about to refill her prescription and only had about a week’s supply left.
When the main drug is unavailable, alternatives quickly “fly off the shelves.” In Ritchie’s experience, however, many drug stores, pharmacies, and warehouses will hold on to those alternatives for their own patients.
No alternatives to the drug were available for Ritchie either. Generic drugs are often made from the same ingredients as the brand-name medication, so they’re subject to the same supply shortages.
Support groups like the Crohn’s and Colitis Foundation, allow patients to coordinate and share information with each other. Ritchie said that the drug shortages are affecting others who have a similar condition as her.
“I feel for the people who don’t have the resources or the assistance, the support or the knowledge to be able to look elsewhere,” She said. “I’m not sure if it’s partly because of the pandemic, but this was happening long before that, and it seems to be getting worse.“
Ritchie says she knows of people who specifically plan their vacations to foreign countries to buy their medications.
When Ritchie went to the United States, she spoke with a nurse practitioner in New York
“[The nurse] said the uptick in Canadians crossing the border for medications has at least doubled in the last couple of years.”
Ritchie said the nurse told her chemo patients were travelling internationally as well to get essential medications. “I can’t even imagine how difficult that would be when you’re already dealing with a chronic illness or, in this case, cancer.”
Members of Ritchie’s group worry that Florida’s recently announced plan to ship drugs from Canada into their state will only exacerbate the drug shortages.
