Published October 5, 2022

Parents, critics want action on kids' pain medication shortage as flu season sets in

Many pharmacies, meanwhile, are rationing stock by limiting per-customer purchases

By Cassandra Szklarski

Experts eyeing a shortage of some kids' pain and fever medications say there are several things governments, retailers and manufacturers can do to combat the months-long supply crunch, but they are up against soaring demand that is intensifying with cold and flu season.

Drug companies including Tylenol maker Johnson & Johnson and Advil producer Haleon have already ramped up production to address a "significant spike" in demand ranging from 20 to 40 per cent above historic highs, said a spokesman for the industry group Food, Health & Consumer Products of Canada.

But the problem is really shaped by demand rather than supply, said Anthony Fuchs, adding that "our members are doing everything that they can."

"Many of our members have told us that they've significantly increased production," said Fuchs, urging the public to refrain from panic buying.

"But we're still seeing that there are shortfalls as a result of demand, typically increasing as we're getting further and further into cold and flu season."

Many pharmacies, meanwhile, are rationing stock by limiting per-customer purchases and putting children's medications containing acetaminophen and ibuprofen — such as liquid and chewable products by Tylenol and Advil — behind the counter to prevent bulk buying.

Danielle Paes, chief pharmacist officer at the Canadian Pharmacists Association described the issue as a "supply challenge" rather than a shortage, but also pointed to increased demand "specifically fuelled by high levels of virus activity."

"And that's both COVID-19 but also other viruses in the community. It is back-to-school season and so that's adding to it," said Paes.

"Some pharmacists may choose to put it behind the counter just so that they can have an interaction with the parent or caregiver and make sure that we can prevent mass purchases," she added.

Still, many parents fear what lies ahead if they can't find medications when they need it.

Calgary mother Tara Collins said she had to scramble when her two boys developed a fever and cold-like symptoms last month. She embarked on a futile search for relief at five pharmacies only to come home empty-handed.

Collins ended up getting two bottles from her mother-in-law, but said she's now running low again.

"(I'm) very concerned knowing I won't be able to find the medicine my children will need to get through that cold, flu or even if we get COVID again,” said Collins, who has three children.

Becca Travadi, also from Calgary, said she resorted to non-medicinal treatments when her six-year-old recently fell sick and is uncertain what the fall and winter season could bring.

"It's terrifying, like, I don't know what you can do," said Travadi, who expects more illnesses to circulate in schools now that masks are largely off.

On Tuesday, federal Conservative health critic Michael Barrett called on Ottawa to employ emergency tools that allow the importation of health products that comply with Canadian regulations, noting that was already done with foreign language-labelled inhalers during the COVID-19 pandemic.

The federal health minister said yesterday that Health Canada was “obviously concerned” about supply issues and has been in touch with manufacturers, pharmacists and provincial and territorial governments.

At the same time, Jean-Yves Duclos cautioned Canadians against stockpiling drugs, insisting "the situation is under relative control.”

Mina Tadrous, assistant professor at the University of Toronto's Leslie Dan Faculty of Pharmacy, also pegged supply woes to soaring demand, noting "there's supply trickling in but it's quickly disappearing."

It's also not easy for drug manufacturers to quickly resolve shortages, he said, pointing to myriad factors that go into production that include the sourcing of raw materials, factory schedules, labour issues, and bottling, labelling and shipping details.

"There's lots of steps and players," said Tadrous.

"And they also don't want to start over-producing because once the factory gets going, they don't want to over-produce them and they're stuck with all this stock. So they're playing a game (in which) ... they want to ensure that they are able to meet the demand that's there but not overshoot. This is a business decision on their end as well."

Tadrous described the past few months as "a classic presentation of how drug shortages work," noting it started with a spring shortage of a specific brand, which in turn sparked secondary strain on alternate products.

As those supplies also dwindled, it seems some consumers stocked up when they otherwise might not have, he said. But he said resorting to emergency imports, as suggested by Barrett, is a step too far.

"I know it's frustrating for everyone, but it's not that dire. We still have so many other options and there's still drugs in the system. It's just not on all the shelves," said Tadrous.

"Realistically, this is probably not the drug you want to pull all the levers for."

Tadrous called instead for more clarity and communication around supply chain issues and timelines.

"Canada is one of the only countries that mandates reporting of drug shortages that gives us a heads-up but I don't think we have full insight into what's happening and where these drugs are actually being made," he said.

"We've made some movements in improving drug shortages but I think there's still lots more to do to make sure that we protect the Canadian drug supply."

-With files from Stephanie Taylor in Ottawa

Banner image: THE CANADIAN PRESS/Joe O'Connal

This report by The Canadian Press was first published Oct. 5, 2022.

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