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Wednesday, 21 November 2012

Oxycodone generic approval - a political mess with public health consequences

For those that follow the debate, back in the beginning of this year numerous provinces delisted oxycodone and severely decrease its access.   The debate at the time was the consequence of poorly prepared drug policy shifts on the large number of prescription drug addicted persons.  Oxycodone loosing public funding DrPHealth Feb 22, 2012.  Many of the predictions have materialized.    

In the subsequent months numerous stories ran that followed the impacts including the rise in heroin use  Calgary Sun article and the substantive costs associated with single oxycodone doses for persons wishing to maintain their addictions.   Limited value in managing the addiction has been documented but is a potential positive outcome. 

Now, in the weirdest of ironic moves.  The very government that started the domino of confusion and angst, has its left hand approving the generic form of oxycodone. 

Remember that one of the key switches that occurred was the maker of OxyCotin restructured the formulation in a harm reduction effort by utilizing slow release drug delivery mechanisms. 

So the basic dilemma  we have a drug that has been demonstrated as unsafe but has not been delicensed totally by Health Canada. Because it is not delisted, and the patent is expiring, Health Canada apparently does not have the power to preclude the licensing of the generic formulations.

It is not bureaucracy run amok – but a symptom of a system that was designed to preclude bureaucratic obstacles in the drug approval process.   That  Minister Aglukkaq would stand up and say that politicians can’t stop the process is an oxymoron – it is the politicians that set the process up so it would not be stoppable. 

As Andre Picard flags in his Globe and Mail piece, the oxycodone situation is unique and requires political leadership Andre Picard on oxycodone.  Regrettably, this federal government has consistently failed to show leadership on health issues – and this is another example of its causing a problem that the provinces will be expected to solve, and have to foot the bill for the associated costs.

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