“Managed” Supply of EpiPen Auto-Injectors Returning to Canadian Pharmacies

in Food Allergy, Food Allergy News
Published: August 23, 2018

After stock of the EpiPen 0.3 mg auto-injector ran out in Canada in August 2018, Pfizer Canada says pharmacies across Canada will begin receiving a shipment of the devices in the last week of August, with more supply expected in September.

Pfizer Canada is currently the sole marketer of epinephrine auto-injectors in the country, and its shortage of the EpiPen (but not EpiPen Jr) has meant many Canadians were left unable to fill orders for the life-saving medicine and device.

Kerri Elkas, manager of corporate affairs at Pfizer Canada, told Allergic Living that the first shipment represents one month’s worth of the usual national volume “for this time of year.” Pfizer would not say how many devices were being shipped, calling this proprietary information.

Elkas says the inventory will be distributed first to “those who have been waiting for their renewals, which is why inventory will continue to be managed through measured national allocation to maintain ongoing supply at pharmacies.”

Allergists and pharmacists have told Allergic Living that “measured national allocation” means the continued rationing of epinephrine auto-injectors in Canada. A supply shortage has been an intermittent problem since January. During the July-August shortage, that meant a maximum of one EpiPen auto-injector per patient. (In Canada, the devices are sold individually and not as a two-pack as they are in the United States).

The depletion of Canadian auto-injector stock has caused a lot of anxiety for families and individuals with allergies. In late July, Allergic Living heard from one woman standing in an Ontario pharmacy who couldn’t buy an EpiPen for her daughter. The girl was recovering in hospital from a first-time severe food-allergic reaction. (The mother eventually found a pharmacy with one, in a city an hour away.) Reports of being left with only expired epinephrine came in from cities like Toronto, Calgary and Vancouver, as well as from more rural areas.

Michelle Nel with her 10-year-old son Nolan.

Michelle Nel, a food allergy mom who lives in the countryside near Prescott, Ontario, contacted Allergic Living on August 19 from hospital. She had just endured her first-ever severe reaction to wasp stings, having been stung while gardening. As her 10-year-old son Nolan has food allergies and has experienced severe reactions, Nel knew she needed an EpiPen and soon. But she hesitated.

“My son needs two EpiPens available at all times. If I used his, we’d likely only have one pen between us – because the shortage meant I probably couldn’t replace it.” Nel eventually did administer one of the boy’s devices as she began to have trouble breathing in addition to extensive hives, and then called 911. “It was an incredibly difficult decision,” she later said. (See CTV News’ report on her situation here.)

For patients experiencing difficulty locating an EpiPen 0.3 mg auto-injector, Pfizer Canada says to call 1-877-EPIPEN1 for assistance in finding a pharmacy with the device in stock.

Pfizer Canada says the EpiPen shortage is due to manufacturing issues. Pfizer Inc., based in New York City, owns the subsidiary that manufactures the EpiPens and generic equivalent auto-injectors which the pharmaceutical company Mylan markets to U.S. distributors. Pfizer Inc. has faced manufacturing delays that have led to shortages in the U.S., U.K. and Australia, as well as Canada.

Read the latest about the epinephrine shortage in the U.S. here.

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