Pharmacists in Canada want to hear more from the federal leaders about what they plan to do to address drug shortages.
The Canadian Pharmacists Association said there have been 178 drug shortages reported since the federal election was called last month.
"It would be good to hear something, but we are hearing deafening silence," Barry Power, senior director of digital content, said about what the association says is a lack of emphasis on the issue.
"It's rather surprising that nobody has mentioned this. There are some fairly high-profile drugs and some lifesaving drugs that are currently difficult to locate, if not impossible, so I find that quite concerning."
The association is calling on federal leaders to work with them on a plan to address drug shortages, including research into the causes and possible solutions.
The group said current reactive measures for dealing with each drug shortage don't help mitigate shortages.
"It would be great if they would at least acknowledge that this is a problem facing the health-care system," Power said. "It would be even better if they had some idea as to how to fix it."
The organization said more than two-thirds of pharmacists deal with drug shortages daily or multiple times a day, estimating that managing shortages can take up to 20 per cent of their shift.
"It seems over the past year it's, I hesitate to use the word skyrocketed, but it's become more prevalent in our day-to -day," said Curtis Chafe, a Halifax pharmacist and chair of the Pharmacy Association of Nova Scotia.
He said the problem is worsening as more commonly used medications are running short.
He pointed to the recent warning about possible shortages of the flu vaccine, the national shortage of blood pressure medications and the recall of heartburn drug ranitidine. Chafe said they've also been having issues with some antidepressants in short supply.
"Any time somebody relies on a medication and they're told that their supply could be disrupted, it's going to cause some stress," he said. "It's a scary situation for them."
The problem has doctors worried, too.
"It's a concern that's always lurking in the background," said Kevin Chapman, director of partnerships and finance with Doctors Nova Scotia.
He said shortages can cause patients to ration their doses, which runs counter to what the doctor has determined is in the patient's best interest.
"It's a worry at a time when individuals are obviously sick and need the prescription."
CBC News asked the Liberals, Conservatives, New Democrats and Greens about their plans to address drug shortages should they win Monday's election.
The Conservatives did not respond to CBC's request, but the Liberals, Greens and NDP all cited a national pharmacare program — and the power of such a program to negotiate with drug companies — as the solution.
But Power said a pharmacare program could be a threat to the drug supply, depending on how it's rolled out.
If there were only one or two brands covered by a national pharmacare program, that would mean little incentive for other manufacturers to supply that type of product to Canada.
"So it could create a shortage of those, and the increasing demand for the drug that is listed could result in a shortage at least short term for that particular drug," Power said.
That trickle effect is what's currently happening with ranitidine. As people turn to less common alternatives, those have started running out, too.
Since 2017, Canadian pharmaceutical companies have been required to report a shortage to Drug Shortages Canada.
Health Canada said manufacturing issues are the most commonly cited cause of drug shortages.
Chafe said consolidation of the as the pharmaceutical supply chain has led to fewer manufacturing facilities.
"You could have multiple brands of a particular medication, but they're all coming from the same facility," Chafe said. "Instead of one brand being affected now, there's a host of other brands that are going to be affected."
Power said Canada does have a working group to tackle drug shortages. But because many manufacturers are based outside Canada, he said, Canada needs to work with other countries to establish more rigorous regulations and standards.
He also said while there has been a lot of work done by Health Canada employees, it doesn't seem to be changing anything on the front lines for pharmacists.
"There's been a lot of talk," Power said. "We need to start making some progress."
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