Empty shelves of children's pain relief medicine at a Toronto pharmacy on Aug. 17.Joe O'Connal/The Canadian Press
Canada has waived bilingual labelling rules and other requirements to bring tens of thousands of doses of children’s pain and fever medicine into the country to help tackle a nationwide shortage. Some of the medications have already arrived and will be heading to hospitals across the country in the coming days, according to Health Canada’s chief medical adviser.
The medications, imported from the United States and Australia, are being sent to hospitals first, where the sickest children are and the need is greatest, Supriya Sharma said in an interview on Friday. But the government is awaiting proposals from pharmaceutical companies willing to ship more product into the country for individuals to purchase over the counter.
“We absolutely understand,” Dr. Sharma said. “It’s distressing to have a child that’s in pain or has a fever.”
The imported pediatric formulations of ibuprofen, sold under brand names Advil and Motrin, arrived in Canada this week and acetaminophen, sold under the Tylenol brand name, is set to arrive next week. The medications have been in shortage across the country for the past few months. The situation has become increasingly challenging in recent weeks, as cases of respiratory syncytial virus (RSV) have started to soar unusually early in many parts of Canada.
While there were some supply issues earlier in the spring, Dr. Sharma said it wasn’t until mid-August that Canada experienced an unusual and significant surge in demand for children’s medication. Other countries with similar virus seasons, namely the U.S. and western Europe, did not experience the same purchasing increase at that time, suggesting that panic buying may be a major contributor to shortages here, Dr. Sharma said.
“It starts and then it snowballs,” she said.
Health Canada is authorizing children’s pain and fever medication prepared for other markets into the country through its exceptional importation rules, which were designed to help alleviate such shortages. That means Canada-specific requirements, such as bilingual labelling, have been waived to meet the urgent need, as long as the products are deemed safe.
“There’s nothing at the regulatory side of things that needs to change. It’s a matter of companies having supply they can bring in to have it available,” Dr. Sharma said.
Health Canada has so far only received proposals for exceptional importation of children’s medication for hospital use, Dr. Sharma said. In addition to hospital needs being greatest, much of the imported doses are in bulk formulation, which would be difficult to send to a community pharmacy for individual sale.
Dr. Sharma said that some manufacturers have indicated they plan on submitting applications for exceptional importation of children’s medicine for the community in the days or weeks ahead.
The challenge then becomes managing the supply and ensuring that some individuals don’t hoard the medication, Dr. Sharma said.
She also highlighted the fact that some alternatives exist to buying pediatric pain and fever medicine off the shelf. For instance, compounding pharmacies have the ability to make those medications for children on site and there are no existing shortages of the raw ingredients used in those processes, Dr. Sharma said.
Emily Gruenwoldt, president and CEO of Children’s Healthcare Canada, said the shortages suggest a need to better prepare for such scenarios.
“We need to have some emergency reserves,” she said.
Karen Gripp, the child health medical director in the emergency department of the Children’s Hospital at the Health Sciences Centre in Winnipeg, said planning can help prevent these types of shortages.
“If the pandemic has taught us anything, it’s that we need to focus on contingency planning,” she said.
Carly Weeks