Pharmacies across the country will likely run out of EpiPens “in the coming days or weeks,” Health Canada is warning. New supplies are not expected until the end of August.
The shortage, which is being blamed by Pfizer Canada on a manufacturing issue, affects adult-dose 0.3 mg auto-injectors, which are used to dispense an emergency shot of epinephrine to people who are at risk of suffering anaphylaxis, a life-threatening allergic reaction that can be triggered by things such as peanuts and insect stings.
“The company has also advised that, at this time, they continue to be able to supply EpiPen Jr (0.15 mg); however, the supply is limited and is being carefully managed at the national level,” Health Canada added in a statement. EpiPen Jr is the child-dose version of the hand-held product.
ONGOING SHORTAGES
Canada has been experiencing an EpiPen shortage since at least January.
“But what’s really changed in the last few weeks is that we’re likely to see a complete shortage during the month of August,” Health Canada’s chief medical advisor, Dr. Supriya Sharma, explained in an interview with CTV News. “So there will likely be a few weeks in August where there won’t be any supply at the pharmacy level.”
Sharma, however, made a point of describing the shortage as “temporary.”
“We’re trying to work with the company to make sure that they have supply, we’re trying to encourage other companies to market their products in Canada and we’re trying to work with people so they can understand how to best distribute the supply that we do have in Canada,” she added. “When we go out and we talk about a shortage, we don’t want to trigger people to get panicked.”
FRUSTRATION AND FEAR
But for those who suffer from and advocate for people with severe allergies, it’s hard not to panic.
“It’s moving from inconvenience to concern,” Jennifer Gerdts, executive director of education and advocacy group Food Allergy Canada, said of the ongoing shortages in an interview with CTV News.
“We’ve heard from a few people just this week (about) going to multiple pharmacies and not being able to access the product,” she said.
Pauline Osena, who owns allergy-friendly restaurant Hype Food Co. in Toronto, has two young sons who carry EpiPens because of multiple severe food allergies.
“We have used EpiPens in the past to save my sons’ lives,” Osena told CTV News. “You know, just a tiny little drop of invisible food could cause a pretty severe reaction.”
Osena, who credits her sons as the inspiration behind her restaurant, even keeps a pair of EpiPens onsite in case of emergencies.
“Anything can happen at any time,” she said. “And carrying that EpiPen is something that helps to give us some security.”
The timing of the shortage couldn’t be worse, says Phil Emberley, director of practice advancement and research at the Canadian Pharmacists Association.
“We’re very worried about this particular shortage because it will impact many Canadians unfortunately in the month of August,” Emberley told CTV News Channel. “Unfortunately, this is quite an acute period for the need for this medication: we have a lot of children going off to camp, we have Canadians going camping this time of year, we have children beginning to get ready for school. This is a time when there’s quite a bit of demand for this product.”
Emberley notes that most allergy sufferers over the age of 10 require the adult version of the product. Twenty per cent of Canadians, he adds, need more than one dose when experiencing a severe allergic episode.
“We know that without medication such as this, a person can die from an anaphylactic reaction,” Emberley explained. “It is incredibly important.”
NO OTHER OPTIONS
Outside of Pfizer’s EpiPen, there are currently no other epinephrine auto-injectors available in Canada, though four other companies -- Kaleo Pharma, Taro Pharmaceuticals, Valeant Canada and Lincoln Medical -- have all received authorization from Health Canada to sell similar products in the country.
“The decision to market a product in Canada is at the discretion of the manufacturer,” a Health Canada spokesperson told CTV News. “Health Canada cannot compel a company to market and supply a product.”
“Really, we would like those companies to bring additional products to Canada,” Sharma added. “This is a situation where we don’t have alternatives.”
Gerdts concurs.
“We’re vulnerable because we have single source of supply for epinephrine and that is EpiPen,” she said. “We need a second product on the market at a minimum.”
Having only one provider in Canada, Osena adds, leaves her “really worried.”
“We’re always at the mercy of this one company,” she said. “I’m just surprised that there hasn’t been something done about it.”
The company behind the EpiPen has also previously come under fire for raising the price of the life-saving devices in the U.S. by more than 500 per cent between 2007 and 2016.
MANAGING THE SHORTAGE
Health Canada is urging allergy sufferers not to stockpile the devices until the shortage is resolved.
“If people are getting a second EpiPen as a backup supply, then (they) potentially should hold off until after the end of August to do that,” Sharma implored. “It’s really important that people don’t stockpile or hoard the medications because that’s really taking that very needed treatment potentially away from somebody that could need it.”
Health Canada is also reminding EpiPen users that the devices expire on the last day of the month indicated on their packaging.
“In light of the shortage, if you are experiencing an anaphylactic reaction and have only an expired auto-injector, use the expired product and immediately contact 911,” Health Canada advised in its statement.
With files from CTV’s medical affairs specialist Avis Favaro, producer Elizabeth St. Philip and The Canadian Press
