Advocacy in Action: June 2026
June 26, 2026
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CSHP is pleased to share an update on the key advocacy and pharmacy practice initiatives that the Professional Practice team has been focused on over the past month.
Drug Shortages Case Management
Tier 3 Shortages
Mesna – NEW! - Tier 3
The supply shortage of preservative-free mesna injection (UROMITEXAN) has been escalated to a Tier 3 due to a possible gap expected in August. Baxter is the sole supplier of the preservative-free formulation, which is being prioritized for pediatric patients and select cases, while available alternatives contain benzyl alcohol and are not suitable for children. Resource documents outlining the anticipated impacts and mitigation strategies have been developed and can be found below:
Dexamethasone – NEW! Tier 3
The shortage of dexamethasone 4 mg/mL injection has been escalated to a Tier 3 due to a potential national shortage beginning in early July. One of the main suppliers, Sandoz, has is experiencing manufacturing delays through October, placing added pressure on remaining suppliers, SteriMax and Juno. Given this medication is widely used in hospitals, the shortage could significantly affect patient care, and a resource document is being created to help guide planning and management.
Calcitriol – NEW! Tier 3
Calcitriol injection has been escalated to a Tier 3 drug shortage following reports of a critically low remaining supply and uncertainty about future access to imported alternatives with U.S.-authorized imports stock estimated to last only a few more weeks. This shortage may particularly affect vulnerable patients, including children who require IV calcitriol and cannot use oral forms. A resource document is being developed to support planning and response to this shortage.
Paclitaxel for Injectable Suspension, Albumin-Bound – ONGOING!
The supply of nab‑paclitaxel (Abraxane) is gradually improving, with both Canadian and U.S.-authorized product becoming available. More than half of Bristol Myers Squibb’s imported supply has already been distributed, and additional product can be accessed if needed. Approximately 12,000 Canadian units are expected by early July, alongside a short‑term supply from Apotex. While no further restocks are currently planned after July, the situation continues to be closely monitored. To learn more about the imported supply, view the communications below:
Ifosfamide for Injection – UPDATE!
To address the global shortage ifosfamide and prevent a national supply gap, Health Canada has approved the exception importation of Chinese-authorized product (1g/vial), which will arrive as Canadian supply runs out. As a last‑resort measure, and due to differences in labelling, storage, and stability, safety guidance and resources have been developed to support safe use and reduce the risk of medication errors.
Cyclophosphamide Injection
The supply of intravenous cyclophosphamide remains highly constrained with ongoing disruptions across multiple suppliers. Launch of MARCAN's Canadian-authorized product has been delayed until early July or August, while ANDONE supply is still being tightly managed with only small releases expected before a larger resupply in August. Other sources remain unavailable with Sandoz and Sterimax out of stock, and Baxter's still on backorder with a possible August return. Healthcare providers are encouraged to continue conservation measures and monitor updates as this shortage persists. CSHP, CPhA, and CAPhO, have developed a clinical resource to help pharmacists and other healthcare professionals manage this shortage. The resource is available here.
Strategic Collaborations
Health Canada controlled drugs regulations
The subsection 56(1) class exemption for pharmacists will expire on September 30, 2026, with amendments to the Controlled Substances Regulations (CSR) will come into effect on October 1, 2026. To support this transition, Health Canada’s Office of Controlled Substances is collaborating with CSHP to update hospital guidance, align it with the new regulations, refresh references, and provide a French translation of the revised document.
Canadian Thoracic Society Inhaler Conversation Aid Tool
CSHP has endorsed and will help amplify the Canadian Thoracic Society’s Inhaler Conversation Aid Tool through its networks and digital platforms. This collaboration contributes to national efforts to advance climate‑conscious inhaler use and patient‑centred decision‑making in respiratory care.
Consultations
CSHP has participated in the following consultations:
- 2026 Palliative Care Services – Public Review - Health Standards Organization Consultation | Submitted: April 15
- View executive summary available here.
- Health Canada Consultation on the Proposed Canadian Access, Watch, Reserve (CAN-AWaRe) Classification of Antimicrobial Drugs for Human Use | Submission Date: June 8
- View executive summary available here.
To catch up on CSHP advocacy news, click here.
Have a question about Advocacy in Action or CSHP's advocacy and consultation work?
Reach out to our professional practice team!