Pharmacy-developed software gave early warning of critical cancer drug shortage

Software developed at the Leslie Dan Faculty of Pharmacy predicted a global shortage of a critical cancer drug months in advance, allowing purchasers to plan ahead and minimize the impact on patients.

The platform, called MaaTRx, uses real-world evidence, advanced analytical modelling, and AI tools to predict drugs that are vulnerable to shortages, providing a dynamic view of risk as market conditions and drug characteristics change.

“This is a good use case of what we’re trying to help people achieve through MaaTRx. We need a paradigm shift in how we should be thinking about drug shortages,” says Mina Tadrous, associate professor at the Leslie Dan Faculty of Pharmacy and co-founder of MaaTRx. “People often feel powerless about drug shortages, but there are things that can be done to mitigate them. And we hope that our tools empower people to be able to make decisions and plan for shortages better.”

“People often feel powerless about drug shortages, but there are things that can be done to mitigate them. And we hope that our tools empower people to be able to make decisions and plan for shortages better.”

According to the Canadian Pharmacists Association, drug shortages are an ongoing concern in Canada, with more than 2,000 drug shortages reported annually. Shortages can happen for a variety of reasons, including supply chain disruptions, changes in manufacturing, or changes in how the drug is used.

Cyclophosphamide is used for chemotherapy for a variety of cancers, including some forms of childhood cancer. Earlier this year, health authorities around the world began reporting shortages of cyclophosphamide. In Canada, Health Canada has classified the cyclophosphamide shortage as “tier 3,” which has the greatest potential impact on Canada’s drug supply and health care system.

This shortage was not a surprise for MaaTRx users. Over a year ago, MaaTRx detected that the market dynamics of cyclophosphamide had changed and flagged the drug as being at risk of a shortage. Several months before the shortage, the signal intensified. As MaaTRx alerted users to the increased risk, they could begin planning to secure additional supplies or look for substitutions.

For Mohawk Medbuy, a not-for-profit shared services organization that negotiates and manages contracts for medical and surgical supplies, equipment, services and medications on behalf of hundreds of hospitals across Canada, this advance alert meant that they could work with international suppliers to secure the medication for the hospitals they support – ensuring that patients didn’t miss their treatments.

“This example showcases that when it comes to shortages, we can be proactive and work ahead of time, and planning things correctly can help prevent some pain,” says Tadrous. “At the end of the day, there are patients in Canada that didn’t have to delay their treatment because of our tools.”

U of T incubator programs helped bring MaaTRx to market

MaaTRx builds on Tadrous’s academic work, which analyzes large data sets of real-world evidence on topics from drug safety and effectiveness to drug shortages. Tadrous and his former graduate student Shanzeh Chaudhry built MaaTRx as an academic pursuit, but they soon realized that they needed to commercialize the tool to broaden its potential impact and ensure its sustainability as an independent platform.

They participated in the University of Toronto Early Stage Technology (UTEST) and Lab2Market incubator programs to support the product’s growth and ensure it could reach potential customers.

MaaTRx, which is partially owned by U of T, is now a suite of tools that monitors and predicts drug shortages, alerts users to emerging risks, delivers evidence-based response plans and substitution strategies, enable responsive inventory sharing and redistribution between sites, and provide a forum for health system partners to share knowledge and coordinate responses. Together, the tools allow users to be proactive in addressing shortages and act quickly to minimize the impact on patients.

Many tools that predict drug shortages are based on a snapshot of information from a particular time and are static, but the recent cyclophosphamide shortage highlights the need for dynamic tools.

“People need to be able to access updated information and dynamic tools that reflect the current environment so that these changes can be put on their radar ahead of time,” says Tadrous.

“Finding solutions and alternatives is far more challenging to do when you’re in a moment of crisis and everyone is grappling with the problem at the same time. By planning ahead, we can be more thoughtful and make more informed decisions that ensure better patient outcomes.”