Drug supply chain issues led to shortages nearly 50% of the time in the U.S. from 2017 to 2021, compared to just 34% in Canada, according to a recent study.

The cross-sectional study evaluated differences in drug shortage risks following supply chain disruptions between the U.S. and Canada from 2017 to 2021. Analysis of 104 drug-related supply chain reports revealed that within 12 months of reported issues, 49% of cases in the U.S. were associated with drug shortages, compared to 34% in Canada (adjusted hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.36-0.79), suggesting approximately a 40% lower shortage risk in Canada. These trends persisted both pre-pandemic (adjusted HR, 0.47; 95% CI, 0.30-0.75) and during COVID-19 (adjusted HR, 0.31; 95% CI, 0.15-0.66).

Published in JAMA, the study highlighted that sole-source drugs faced a higher risk of shortage in both countries (adjusted HR, 2.58; 95% CI, 1.57-4.24). Additionally, Canadian tier 3 medications, classified as moderate risk, demonstrated a nearly 50% lower likelihood of shortages compared to the U.S. (adjusted HR, 0.56; 95% CI, 0.32-0.98). Canada’s mandatory reporting requirements and its centralized regulatory response, which includes collaboration with provincial payers and a national drug stockpile, are associated with a lower shortage risk. Conversely, the U.S. regulatory framework, while comparable, does not include the same level of federal and payer coordination observed in Canada.

These findings highlight differences in drug shortage risks that may inform future policy discussions on mitigating supply chain disruptions. The Canadian approach—characterized by mandatory reporting, targeted stockpiling, and public payer collaboration—is associated with a lower shortage risk, offering insights that may be relevant to U.S. policy discussions on drug supply resilience as shortages continue to impact patient access.

Full disclosures can be found in the published study.