Ontarians stockpiled prescription medications at beginning of pandemic, according to new drug monitoring tool

By Maria Sarrouh

In mid-March, Ontarians stockpiled inhalers and there was a 19.2 per cent spike in the dispensing of Hydroxychloroquine, a malaria medication promoted as a possible treatment for COVID-19 that has since proven to be ineffective, according to a new interactive tool launched Thursday by scientists at the Ontario Drug Policy Research Network (ODPRN).

The COVID-19 Ontario Prescription Drug Utilization Tool provides ongoing surveillance of prescription drug trends that allows policy makers, clinicians and the public to inform their COVID-19 planning decisions with the best evidence possible as the pandemic progresses. As the risks of the pandemic evolve, so will the impact of drug shortages on patients, healthcare professionals and the healthcare system.

The tool monitors prescription drug utilization trends across the province and reports weekly trends of individuals who were dispensed a prescription drug or received a pharmacy service from 2016 onwards.

“There’s a real concern that COVID-19 related drug shortages can negatively impact people’s health if they can’t get the medication they need,” said Dr. Tara Gomes, a scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and ICES, and a principal investigator of ODPRN. “Being able to monitor these trends, and see how policies as well as clinical practices are changing the way in which the drug supply is being used, can help us avoid drug shortages and adapt more quickly.”

Key findings on how the pandemic has impacted drug supply and the way medications are dispensed can be seen in the data presented by the tool. One trend that is evident is the stockpiling of inhalers.

“During a pandemic that has respiratory implications, there was clearly a concern among people with respiratory problems that they might not be able to access their inhalers,” said Dr. Gomes. “Although there was a shortage of some inhalers during the pandemic, a rapid policy response helped source new products to avoid a gap in access for Ontarians. It is hoped that this tool can continue to help policy-makers react quickly to disruptions in medication access for patients across the province.”

The tool also shows a 21 per cent increase in demand for flu shots over the previous year. This trend will be important to monitor over the coming winter months as demand for the flu shot has been high and broad access is needed to reduce the burden of influenza on hospitals.

Additionally, more frequent dispensing of chronic medications — like drugs used to treat high blood pressure and diabetes — is seen in the data, a trend that was expected by the scientists at ODPRN. The trend was symptomatic of policies limiting the size of prescriptions implemented by the Ministry of Health to mitigate the risk on the drug supply during a pandemic, and has reversed since restrictions have eased.

“There is evidence to suggest that all the news that comes out about potential treatments and how to deal with COVID-19 impacts the way people use medication,” said Dr. Mina Tadrous, a scientist at Women’s College Hospital and ICES, and an investigator with the ODPRN. “Even in Canada, we saw a spike in people trying to get Hydroxychloroquine around the time all the tweets and news came out in March. So, we’re not protected from misinformation here.”

The information included in the tool was captured using the Ontario Drug Benefit database, which contains records of dispensed drugs and pharmacy services that are reimbursed through Ontario’s publicly-funded drug program. It also uses data from the Ontario Narcotics Monitoring System, which contains all prescriptions for controlled, and monitored substances dispensed from all community pharmacies in Ontario. As new data emerges, the tool will be updated and expanded to include any new drugs and illustrate trends. The findings are intended to provide an early indication of how trends are continuously changing to facilitate rapid policy and clinical responses.

“I think we saw first-hand how dynamic this is,” said Dr. Tadrous. “Unfortunately, for a lot of sectors, COVID-19 showed the cracks in the system. Misinformation, stockpiling and drug shortages were all problems we had before this. During this pandemic, it just became more obvious.”

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.