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‘Why would any parent purchase this?’: Alberta-imported children’s pain medication a different concentration, requires education

Children’s Tylenol sits on a shelf at a pharmacy on Wednesday, Nov. 9, 2022 in Ottawa. THE CANADIAN PRESS/Adrian Wyld

Parents looking for children’s pain medication will soon be getting an alternative.

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But details released by Alberta Blue Cross this month shows the Turkish-manufactured liquid acetaminophen for kids is at a different concentration than what is normally approved by Canadian authorities.

The medication will be sold under the “Parol” brand name.

“Parol is a 24 mg/ml oral suspension, which comes in a 150 ml size child-resistant glass bottle with a graduated spoon and in an orange flavor,” Alberta Blue Cross wrote in its brief sent to pharmacists provincewide. “It is important to know that this differs from the Canadian-authorized product which comes in a concentration of 32 mg/ml and uses a different dosing device.”

The memo goes on to say that Parol must be kept behind the counter and pharmacists are expected to educate parents and caregivers on the correct usage of the drug that got an emergency approval from federal authorities.

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“They want to make sure that parents are being properly educated about how to use a measuring spoon, what the dosage is, and make sure that it’s going to be dispensed in a safe manner,” Randy Howden, president-elect of the Alberta Pharmacists’ Association, told Global News. “It’s just different than what we’re used to seeing in Canada.”

Mathieu Giroux, a pharmacy licensee at Cambrian Pharmacy, said there will be increased demand for his and his staff’s time because of the requirement to educate parents and caregivers on how to use Parol properly.

“Usually it’s something that we wouldn’t necessarily have to discuss,” Giroux told Global News.

The suggested retail price for a bottle of Parol is $11.99.

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Children’s pain medication has been in high demand and low supply for the past six months.

“It seems to have been busier this fall for sure. And I don’t think we were prepared for the volume that was going to come in due to the drug shortages because they just snuck up on everybody,” Howden said.

On Dec. 6, 2022, the province announced it secured a supply of five million units of acetaminophen and ibuprofen from Turkey-based manufacturer Atabay Pharmaceuticals. The first shipment of 250,000 bottles landed on Jan. 18, 2023, for use in hospitals.

On Jan. 26, Health Canada approved an “exceptional importation,” but matters like labelling needed final approval.

At a recent committee meeting, Health Minister Jason Copping told Edmonton-Whitemud MLA Rakhi Pancholi the total bill for the buy from Atabay was $80 million: $70 million for the medication and $10 million for “shipping, waste disposal and other administration.” That works out to about $16 per bottle.

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Pancholi recognizes there was an urgency to get Alberta parents and their children some pain relief at a formulation that was appropriate for children.

“I’m certain that was part of the intention behind the government,” Pancholi told Global News on Friday. “But I’m also equally certain that part of the reason why they did this was because they were in a rush at every opportunity possible to try to show up the federal government and try to prove something in their ongoing political spat with the federal government.

“That was obviously what propelled them into a very bad deal for Albertans.”

The Ministry of Health says some pharmacies in Alberta are still running into supply shortages of kids pain meds.

“Parents need assurance they will have access to this medication for the foreseeable future as the shortage situation stabilizes,” Scott Johnston, Copping’s press secretary, said in an email to Global News.

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“An update about the government’s efforts to address this medication shortage will be provided in the coming days.”

Howden, also a pharmacist/owner of some Calgary Medicine Shoppe locations, said generics and brand names like Tylenol are more readily available, but other brand names like children’s Advil is “still a little hard to get.”

“The good news when it comes to infant preparations for Tylenol on Advil is that pharmacists can work with parents to calculate doses of the children’s version to make sure that they’re getting the right doses,” he said.

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Pancholi, who is the Opposition critic for children’s services and a mother, said the Turkish product is likely to be less desirable to parents.

“Why would any parent purchase this product? If they have what they already know at a dosage they’re familiar with and a flavor they know their kids will take, that’s what they’re going to purchase,” she said.

Pancholi said the added education requirement is another barrier for parents to get pain and fever medication for ailing children, adding “the demand is simply not there.”

Pancholi worries Alberta will be stuck with a high number of bottles of children’s pain medications “for which there is no demand.”

Johnston said the province is willing to help other provinces obtain federal approval for additional supply to address similar medication shortages.

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“What we should expect from a government is that they go into big contracts and agreements and actions like this with the right intentions and that they do it wisely, that they are still conscious of the fact that they’re responsible for taxpayer dollars, and that they have to deliver what they promised for the money that they have paid,” Pancholi said.

“I seriously wonder whether or not many pharmacists would take this product at all.”

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Giroux said he hasn’t yet decided on how much Parol he’ll stock at Cambrian.

“When it comes available, we’ll probably order a little bit to have on hand and see if the demand is there.”

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