Pharmacies across the country will likely run out of EpiPens 鈥渋n the coming days or weeks,鈥� . New supplies are not expected until the end of August.
, 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.
鈥淭he 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,鈥� 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.
鈥淏ut what鈥檚 really changed in the last few weeks is that we鈥檙e likely to see a complete shortage during the month of August,鈥� Health Canada鈥檚 chief medical advisor, Dr. Supriya Sharma, explained in an interview with 麻豆传媒. 鈥淪o there will likely be a few weeks in August where there won鈥檛 be any supply at the pharmacy level.鈥�
Sharma, however, made a point of describing the shortage as 鈥渢emporary.鈥�
鈥淲e鈥檙e trying to work with the company to make sure that they have supply, we鈥檙e trying to encourage other companies to market their products in Canada and we鈥檙e trying to work with people so they can understand how to best distribute the supply that we do have in Canada,鈥� she added. 鈥淲hen we go out and we talk about a shortage, we don鈥檛 want to trigger people to get panicked.鈥�
FRUSTRATION AND FEAR
But for those who suffer from and advocate for people with severe allergies, it鈥檚 hard not to panic.
鈥淚t鈥檚 moving from inconvenience to concern,鈥� Jennifer Gerdts, executive director of education and advocacy group , said of the ongoing shortages in an interview with 麻豆传媒.
鈥淲e鈥檝e heard from a few people just this week (about) going to multiple pharmacies and not being able to access the product,鈥� 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.
鈥淲e have used EpiPens in the past to save my sons鈥� lives,鈥� Osena told 麻豆传媒. 鈥淵ou know, just a tiny little drop of invisible food could cause a pretty severe reaction.鈥�
Osena, who credits her sons as the inspiration behind her restaurant, even keeps a pair of EpiPens onsite in case of emergencies.
鈥淎nything can happen at any time,鈥� she said. 鈥淎nd carrying that EpiPen is something that helps to give us some security.鈥�
The timing of the shortage couldn鈥檛 be worse, says Phil Emberley, director of practice advancement and research at the Canadian Pharmacists Association.
鈥淲e鈥檙e very worried about this particular shortage because it will impact many Canadians unfortunately in the month of August,鈥� Emberley told 麻豆传媒 Channel. 鈥淯nfortunately, 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鈥檚 quite a bit of demand for this product.鈥�
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.
鈥淲e know that without medication such as this, a person can die from an anaphylactic reaction,鈥� Emberley explained. 鈥淚t is incredibly important.鈥�
NO OTHER OPTIONS
Outside of Pfizer鈥檚 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.
鈥淭he decision to market a product in Canada is at the discretion of the manufacturer,鈥� a Health Canada spokesperson told 麻豆传媒. 鈥淗ealth Canada cannot compel a company to market and supply a product.鈥�
鈥淩eally, we would like those companies to bring additional products to Canada,鈥� Sharma added. 鈥淭his is a situation where we don鈥檛 have alternatives.鈥�
Gerdts concurs.
鈥淲e鈥檙e vulnerable because we have single source of supply for epinephrine and that is EpiPen,鈥� she said. 鈥淲e need a second product on the market at a minimum.鈥�
Having only one provider in Canada, Osena adds, leaves her 鈥渞eally worried.鈥�
鈥淲e鈥檙e always at the mercy of this one company,鈥� she said. 鈥淚鈥檓 just surprised that there hasn鈥檛 been something done about it.鈥�
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.
鈥淚f 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,鈥� Sharma implored. 鈥淚t鈥檚 really important that people don鈥檛 stockpile or hoard the medications because that鈥檚 really taking that very needed treatment potentially away from somebody that could need it.鈥�
Health Canada is also reminding EpiPen users that the devices expire on the last day of the month indicated on their packaging.
鈥淚n 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,鈥� Health Canada advised in its statement.
With files from CTV鈥檚 medical affairs specialist Avis Favaro, producer Elizabeth St. Philip and The Canadian Press
