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OPINION: National system needed to ensure children’s medicines are available

The Cold and Flu section
The Cold and Flu section at this Shoppers Drug Mart store is bare -- especially the children's variety. Photo by Jack Boland /Toronto Sun

By Christine Donaldson

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Last fall, on a flight from Edmonton to Toronto, I was seated near a family with a visibly sick baby. I overheard them telling the flight attendant they couldn’t get amoxicillin or infant acetaminophen (Tylenol) before they took off and had sent family ahead of them to find some before they landed.

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The news was full of similar stories — common children’s medicines were impossible to find in Canada, prompting Canadians living near the U.S. border to stock up from American stores.

Unfortunately, the same factors that caused so much health-care disruption in 2022 – a disconnected system and no national reserve stock of vital children’s products – still exist today. We need to act now to ensure families with young children are taken care of now that the next flu season begins.

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The problem with access to medications is easily described, but harder to address. In short, the usual summer lull in demand that manufacturers of essential medications rely on to build their inventory didn’t happen in 2022 due to an earlier and higher-than-normal rate of summer infections. Production never got ahead of demand before the fall surge. This phenomenon appears poised to repeat itself this year and suppliers in Canada are worried.

They should be. Last year’s experience was awful. Emergency rooms across Canada were filled with young children struggling with high fevers and other symptoms from infections and viruses, in need of the most basic medications their parents couldn’t find in stores. Some hospital pharmacies even struggled to keep enough inventory to meet the demand.

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Even now, with another shortage possible, hospitals continue to struggle with how to identify their own supply gaps and communicate about them. In many regions, hospital staff cannot reliably tell you what they have in stock unless they are in the supply room looking at it. In Ontario, the province’s 141 hospital corporations are not connected to one another through an integrated platform. If a hospital in northern Ontario needs amoxicillin, it cannot see a hospital in the southwest region has supply it could request. Often, staff can’t even see what a hospital neighbouring their network has.

This is not an unreasonable thing to expect of a modern health-care system. In Alberta and Nova Scotia, for example, the entire provincial hospital system operates under one central administration with a single, shared inventory. These are models that every province should replicate. In addition to centralizing provincial inventories, we should create a national reserve stock of vital children’s products.

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We need this centralization and reserve stock because Canadian hospitals account for just 2% of the global market. As a minor player in the global market, we can struggle to procure necessary supplies and medicines in a timely way. To secure reliable supply, we need to bring provinces together to purchase in bulk — as we did last year to secure children’s acetaminophen from Australia. And in a crisis, we need to be able to compete on price.

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We have learned first-hand how vulnerable Canada is and the significant risks these shortages pose. When children’s dosages weren’t available, some parents resorted to the risky practice of splitting adult pills to relieve their child’s pain or fever. In Ontario alone, this contributed to a more than 50% surge in calls from parents and hospitals to the Ontario Poison Centre about acetaminophen and ibuprofen dosing errors. Ahead of another busy flu season, parents should know that if needed, their local pharmacist can provide instructions tailored for the specific weight and age of their child.

Canada continues to struggle with a disconnected hospital system and insufficient inventory. And we’re just starting on the path to producing more essential medicines domestically. It is imperative we get ahead of shortages by creating a national reserve stock of vital children’s products before surges in demand occur. We must implement a national, proactive approach to securing more through trusted supply chains – today. By working together at all levels, we can protect our most vulnerable patients from any future harm.

Christine Donaldson is president and CEO of HealthPRO Canada

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