CRA Update on HCQ Shortage in Quebec - April 1, 2020

Dear CRA members,

As our colleagues in Quebec are aware, there is a shortage of HCQ in Quebec that has prompted INESSS (CADTH’s counterpart for Quebec) and College des médecins to ration HCQ in order to prevent a shortage for ​rheumatology patients deemed most in need. As of late Friday March 27th, they mandate that only SLE (they specify systemic), paediatrics patients and pregnant woman are allowed access. For any other indication, a substitute will have to be found because they are not renewing prescriptions.
Carter Thorne, CRA’s Stakeholder Committee Chair, has been in contact with INESSS to clarify events leading up to this rationing and the outlook for Quebec rheumatology patients previously on HCQ.
INESSS has clarified that there is NO planned diversion of HCQ inventory from rheumatology patients towards COVID-19 applications. However, recent excess ‘off-label’ prescriptions for HCQ exhausted available inventory, and INESSS anticipates a further shortage of the usual supply due to an export ban on shipments and other supply chain challenges. The rationing of HCQ was therefore implemented in reaction to this shortage and will be in place until the shortage is reconciled. They anticipate the shortage will likely be less than 6 weeks in duration. 
Patients will be given an information sheet explaining the reason for the shortage and reassuring them that they will get back on their drug as soon as it becomes available. The pamphlet will also inform them to contact their physician should they experience a flare.
INESSS further confirmed that in the future, hospital allocation of HCQ for COVID-19 use will be based on delivery of product resourced for that specific purpose. An example of this is the recently announced donation of one million doses of hydroxychloroquine by JAMP Pharma Group to Canadian hospitals for COVID-19 management.
The CRA will continue to monitor the situation across Canada. Where necessary and possible, we will gather information, advocate for our members and their patients, and provide you with updates as new information becomes available.

Copyright © 2020 Canadian Rheumatology Association, All rights reserved.

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