Canada seeks US help to solve EpiPen shortage

EpiPen auto-injection epinephrine pens manufactured by Mylan NV pharmaceutical company for use by severe allergy sufferers are seen in Washington, US August 24, 2016. (Reuters pic)

TORONTO: Canada said on Tuesday it is working with the US Food and Drug Administration to access supplies of Mylan NV’s EpiPen emergency allergy antidote amid a global shortage that has spared the United States.

EpiPens deliver a potentially life-saving dose of the generic drug epinephrine via an automatic injector. They are all made at a single Pfizer Inc facility near St Louis, Missouri.

Last week, the company notified consumers in Canada and Britain that the device is in short supply due to manufacturing problems. In response to a Reuters query, Pfizer said that there was no shortage in the United States and that Mylan decides how EpiPens are allocated to different countries.

The restricted supply is particularly worrying to doctors and families in Canada, where no alternatives to the EpiPen are sold. Health Canada has told consumers to use expired EpiPens and call 911 in an emergency.

“There’s not a robust supply in Canada. And there may not be for a while,” said David Fischer, president of the Canadian Society of Allergy and Clinical Immunology. “We’re all perplexed about the whole concept of this worldwide shortage that does not involve the US.”

The US market is the most lucrative for EpiPen, where a two-pack of the generic injectors retails for US$300. In Canada, a single EpiPen can be bought for US$100, while the UK National Health Service price for a single dose is closer to US$38.

Health Canada, the government health department, is discussing with Pfizer and the FDA ways to minimize the impact of the shortage, “including exploring access to international supply,” said Rebecca Purdy, a Health Canada spokeswoman.

Pfizer Canada spokeswoman Kerri Elkas said the company “is working diligently to increase production and expedite shipments to Canada as rapidly as possible.”

Officials at Mylan and the FDA were not immediately available for comment.

Recalls, manufacturing lapses

Meridian Medical Technologies Inc, the Pfizer unit that manufactures EpiPens, has been hit by a series of manufacturing problems. In March 2017, Mylan recalled tens of thousands of devices after complaints that some failed to activate.

In September, Meridian received an FDA warning letter saying it had failed to thoroughly investigate product failures or take corrective actions until FDA’s inspection. At the time, Mylan said it did not anticipate any impact on EpiPen supply based on the warning letter.

Health Canada said that four companies have authorization to sell epinephrine auto-injectors — Kaleo Pharma, Taro Pharmaceutical Industries Ltd, Valeant Pharmaceuticals International Inc and Lincoln Medical Ltd — but none are currently marketing them in the country.

In the United Kingdom, two rival products are approved for sale from Danish drugmaker ALK-Abello and from Valeant’s Bausch and Lomb division.

In Toronto, Amy Morrell keeps four EpiPens to protect her 5-year-old son from a life-threatening peanut allergy. She keeps them at home, at his school and in his backpack.

She has not had trouble yet filling a prescription. But if supply were disrupted, she said, “it just wouldn’t be acceptable.”

“We wouldn’t be able to leave the house,” she said. “It would be life-changing – for him, and for us.”