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“We play a role in filling those gaps, which, if we weren’t here, patients would have nowhere else to go,” Pillay said.

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The ideal situation would be that there aren’t as many shortages, Pillay explained.

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But in the meantime, he says Ottawa’s growing compounding pharmacy practices are stepping in where needed.

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Compounding pharmacists feel pressure

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Pillay says he has three dedicated employees who only do compounding work full-time at his pharmacy in the Glebe.

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“They spend all day just making (medications) because we supply not only to our own patients, but patients from other pharmacies that refer people to us for those compounds because they aren’t able to do it.”

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It’s a testament to the pressures compounding pharmacies are witnessing as drug shortages continue to persist province-wide, Pillay says.

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“It adds to our workload and pressure (because) sometimes patients need (medications) very urgently because they’re not available (commercially),” he said. “We kind of have to juggle our schedule around to try and accommodate.”

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Despite the added pressure, Pillay says compounding pharmacies are in a “unique position” to provide more alternatives than a pharmacy that doesn’t compound.

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Pharmacists in the middle

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Pharmacists spend up to 20 per cent of their time managing drug shortages, according to Canadian Pharmacist Association chief pharmacist officer Sadaf Faisal.

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“If you look at Health Canada’s drug shortage website, at any given time, you can see that there could be up to 2,000 active drug shortages,” Faisal said in an interview.

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But not all of them actually reach the public consciousness.

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“(This is) because pharmacists are working in the background trying to find out alternative solutions,” Faisal added.

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“This means pharmacists will contact the prescribing doctor to get the medication covered.”

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Should pharmacists have a wider scope of practice?

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Faisal explained that in some jurisdictions across Canada, pharmacists are able to suggest an alternative drug if the prescribed medication is commercially unavailable.

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This expanded scope of practice is another viable solution to ease and better manage drug shortages in the province, she said.

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“If one medication goes on shortage, your pharmacist … will be able to work with your provider so your prescription can get switched,” Faisal said.

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Ontario and Manitoba are the only provinces in Canada where pharmacists aren’t able to make this suggestion.

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While earlier this year, Ontario announced it would allow pharmacists to administer vaccines for six different diseases and prescribe for nine “common ailments,” Faisal says one of the national association’s advocacy goals is to get Ontario pharmacists the ability to suggest alternative drugs for products experiencing a shortage.

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Moving forward

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For those like Proulx, the anxiety coupled with drug shortages is only the tip of the iceberg of the pre-existing pain and fatigue from living with a long-term illness.

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Proulx says she witnesses dozens of people like her who experience the uncertainty that comes with drug shortages while navigating chronic illness.

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Proulx added that many find out about the shortage at pharmacy counters when they’re greeted.

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“If this is going to be our new reality …. how can we better support people? So that they are not so surprised and they know what to do.”

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Drug shortages, according to Health Canada’s explanation, can occur for a variety of reasons, including problems or delays in manufacturing, difficulty getting access to raw ingredients, or a sudden increase in demand.