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A compound solution for the children’s medication shortage

Compounding Pharmacist, Andrew Hanna, can use the active ingredients in many popular brand name medications to quickly make pills and liquid solutions. Ottawa, Ont. Nov. 17, 2022. (Tyler Fleming/CTV News Ottawa). Compounding Pharmacist, Andrew Hanna, can use the active ingredients in many popular brand name medications to quickly make pills and liquid solutions. Ottawa, Ont. Nov. 17, 2022. (Tyler Fleming/CTV News Ottawa).
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Children’s medicines remain in short supply at pharmacies in Ottawa and across the country and it is getting worse. Now, adult pain and fever drugs are running out, adding to a growing list of others, which dwindle in supply.

But there's an immediate solution to solve part of this problem for both pills and chewable tablets: compounding.

"We’ve had shortages throughout the pandemic and it’s only gotten worse," says pharmacist Andrew Hanna, owner at Pharmasave Avalon Compounding Pharmacy. "And we’ve been compounding them since the spring when we first saw the shortage. We use the API, which is the active pharmaceutical ingredients, and we use that to make medication. It’s been very busy, we’ve had a lot of people come in and we’ve had a lot of support from our suppliers.”

At the pharmacy, inside a special 'clean room', Hanna and his team can quickly make pills, chewable tablets or liquid solutions of popular brand name children or adult medication brands, such as Tylenol and Advil. 

"We can make it more palatable and tweak it to their weight and size," Hanna says. "We’re looking at few dollar differences between what is retail brand and what is compounded."

Hanna says it has been busy, especially as many pharmacy selves remain empty.

Health Canada has secured a foreign supply of children’s medication to restock pharmacies, but that is likely still weeks away, as more drugs such as allergy relievers, adult cough syrup and antibiotics shrink in supply.

"There are some really concerning medication on there in terms of their place in therapy and what the potential alternatives would be," says Jen Belcher, vice president, strategic initiatives and member relations with Ontario Pharmacists Association. "The rate of drug shortages has been increasing over the past five to ten years and we are absolutely struggling more with prescription and over-the-counter drug shortages than ever before. This definitely accelerated throughout the COVID-19 pandemic with global supply changes, changes with demand patterns.”

Belchers says the growing increase of drug shortages creates an additional burden in the provision of care and that government, along with all levels of healthcare, must look at ways to mitigate this problem and to allow pharmacists more ability to provide choice.

“The prescription drug shortages are nothing new unfortunately to pharmacy teams and health care providers,” she says. "And as a pharmacist, I can’t change someone’s medication from one prescription to another if it's in back order situation."

The amount of children’s medication Health Canada has secured is unclear. All the federal agency would say is that it will help address the immediate situation. But pharmacies do not know how the supply will be distributed and who will get it.

As for why Canada has a shortage in children's drugs, while America does not, Belcher says there may be a few reasons.

“This is out of the ordinary for when we would see demand on these products," Belcher said. "We’ve seen a spike here in that demand that hasn’t been observed in the United States, they may have had a more robust supply within their existing network but the level of demand hasn’t surged the way we’ve seen it in Canada."

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