Drugs used as a last resort to treat patients with severe forms of COVID-19 are starting to run out in hospitals in Quebec due to the sharp increase in hospitalizations.
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Tocilizumab and sarilumab, two drugs that are used in intensive care, are currently subject to tight inventory management and could run out in the coming weeks, according to several sources contacted by our Bureau of Investigation.
According to our information, at least three hospitals in the Montreal region each have only about ten doses, including the Maisonneuve-Rosemont hospital.
“The shortage is real. We are not going to put our heads in the sand, ”says Dr François Marquis, intensivist at Maisonneuve-Rosemont hospital.
These two drugs represent one of the last hopes for patients in acute respiratory distress.
They are used to reduce inflammation and are given to patients in an attempt to prevent their intubation.
The National Institute of Excellence in Health and Social Services (INESS) published in May 2021 a note in which it already mentioned an “anticipated shortage of tocilizumab”.
This shortage is due, according to the INE, to the “recent demonstration of the benefits of an intravenous (IV) injection of IV tocilizumab on the mortality of patients with COVID-19 having recourse to oxygen therapy”.
The hospital must rationalize
“We have put in place a rationalization system. You can’t order it. […] What I can tell you is that in my hospital, there is no longer anyone who has the right to prescribe it except oncologists and intensivists. It’s crossed out at the pharmacy, ”says Dr Marquis.
He said tocilizumab was first developed to treat cancer patients. However, its usefulness has also recently been demonstrated “in severe COVID”.
“We won’t give it away lightly. From there to saying that we are going to prevent ourselves from giving it to someone who needs it, we are not there yet, but that can change in two weeks, ”he explains.
Pressures on stocks
The Ministry of Health confirmed to us by email that “the large number of hospitalizations for patients with COVID-19 puts pressure on the inventories of certain drugs more specific to their treatment”.
However, he did not want to give the precise figures of the doses currently in stock in hospitals “for strategic reasons”.
According to the ministry, tocilizumab and sarilumab are used in the treatment of COVID-19, essentially for the same indications.
For several months, most of the supplies of these two drugs have come from federal government allocations to the provinces.
“Global demand for these products is very high and the quantities available are therefore very limited,” explains Laura Fitzback, spokesperson for the ministry.
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