How to Source a Hard-to-Find Medicine in Canada: A Procurement Checklist for Hospitals and Clinics
A step-by-step checklist for hospital and clinic procurement when a medicine is short, dormant or not marketed in Canada — which route applies, what to verify, and what to ask a supplier for.
Start with the regulator's own record
Before contacting any supplier, confirm the product's Canadian status in the Health Canada Drug Product Database (DPD). The DPD entry tells you whether the DIN is Marketed, Dormant, Approved or Cancelled, who the company of record is, and when the status last changed [1]. A dormant or cancelled DIN cannot simply be re-ordered from a Canadian wholesaler; the route changes.
Next, check whether the product is on Drug Shortages Canada. Reporting there is mandatory for market authorization holders, so an active shortage record is the strongest signal that domestic supply will not resolve quickly [2].
The four situations and their routes
1. DIN marketed, no shortage. Order through a licensed wholesaler. Ask for the Drug Establishment Licence (DEL) number of the wholesaler and check it on Health Canada's DEL search; wholesaling without a DEL is unlawful in Canada [3].
2. DIN marketed, shortage reported. Ask the wholesaler for same-ingredient marketed alternatives (the DPD lists every DIN sharing the active ingredient). If none is available, Health Canada may issue an exceptional importation and sale notice for a specific foreign product; only products named on that list may be imported under it [4].
3. DIN dormant or cancelled. Supply comes from a foreign market through the Special Access Programme (SAP): a practitioner requests the drug for a named patient, Health Canada authorizes, and a licensed importer brings it in [5].
4. No Canadian DIN at all. SAP is the route for patient care; clinical trials use a Clinical Trial Application (CTA) instead.
What to ask a supplier for
- Health Canada DEL number and the activities it covers (import, distribute, wholesale) [3].
- For foreign product: the source-market registration number and marketing authorization holder, so you can verify it in that regulator's register.
- Certificate of Analysis, lot number, expiry, and storage/temperature record for the shipment.
- Written confirmation of the regulatory basis (SAP authorization number, exceptional importation notice, or Canadian DIN).
Lead times you should expect
Domestic marketed product: same or next day from most wholesalers. SAP product from a regulated foreign market: typically 10–21 days once the SAP authorization is issued, driven by export release and air freight. Cold-chain products add packaging validation time.
Where Nexara Health fits
Nexara Health is a Health Canada-licensed wholesaler (DEL #3-002896). For each DIN we publish the regulator record, same-ingredient alternatives, and the same-molecule registrations in other markets, so you can see the fallback route before you need it. Search a product in the [Canadian drug search](/public-search) or open its DIN page.
Sources
[1] Health Canada, Drug Product Database online query — https://health-products.canada.ca/dpd-bdpp/
[2] Drug Shortages Canada, mandatory reporting — https://www.drugshortagescanada.ca/
[3] Health Canada, Drug Establishment Licences — https://www.canada.ca/en/health-canada/services/drugs-health-products/compliance-enforcement/establishment-licences.html
[4] Health Canada, exceptional importation and sale of drugs (List of drugs for exceptional importation) — https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-shortages/exceptional-importation-sale.html
[5] Health Canada, Special Access Program for drugs — https://www.canada.ca/en/health-canada/services/drugs-health-products/special-access/drugs.html