Are you paying too much for your kids' medicine?

Drug company marketing schemes result in pain in the pocketbook for parents

By: Penney Kome

  The next time your child spikes a fever, you may be wise to put away that bottle of Children's Tylenol and reach for the grown-up medication. Junior will be appropriately medicated, and you'll save yourself a pile of dough. That's because, according to a recent Straight Goods investigation, children's painkillers and cold remedies cost at least twice as much per dose as exactly the same drugs marketed for adults.
  Though infants and children younger than three might indeed need special diluted preparations, for children over six, the active ingredients and the dosage are usually the same as adults' medications.
 

The bottle of Children's Advil holds ten 200 mg doses for $6.50, or 65 cents per child's dose, compared to nine cents per dose for adult-strength pills

  Take a look at Advil, an ibuprofen-based medication that targets pain and fever. (Children's aspirin is hard to find, due to the rare but serious occurrence of Reye's syndrome in some children who take aspirin for flu or chickenpox.) Adult Advil costs $8.99 for a package of 100 tablets at 200 mg each. Usually one tablet is enough. That's nine cents a dose.
  Children's Advil, further along the shelf, costs $6.49 for 100 ml (liquid), with 100 mg per five ml. That would be 2,000 mg in the entire bottle, or about 20 adult tablets. A six-year-old should take two teaspoonfuls - equivalent to the 200 mg adult dose - and in fact, the label recommends larger amounts for children eight to 12 years old. The bottle holds ten 200 mg doses for $6.50, or 65 cents per child's dose, compared to nine cents per dose for adult-strength pills.
 

A pharmacist confirmed that the same child could safely take one adult tablet for 10 cents with exactly the same fever-relieving and pain-relieving benefits

  Same thing happens with Motrin, except that the adult product costs more, $9.99 per 100 tablets. That's 10 cents a dose. Children's liquid Motrin costs the same as children's Advil, $6.49 for 100 ml at the same strength or 65 cents and up per dose, for an older child. Children's Motrin also comes in tablets, $6.99 for 16 x 100 mg tablets. An older child would take two tablets, at a cost of 87 cents. A pharmacist confirmed that the same child could safely take one adult tablet for 10 cents with exactly the same fever-relieving and pain-relieving benefits.
  Tylenol, the best-known brand of acetaminophen, costs $7.99 for a bottle of 100 x 500 mg tablets. An adult can take the recommended two tablets for 16 cents per dose. Children's Tylenol liquid costs $4.99 for 100 ml, with 160 mg per five ml. That means 15 ml delivers 480 mg, about one adult dose. With six or seven 15 mg doses in the bottle, a child's dose costs 70 or 80 cents, several times more than the adult dose.
  Even with a generic children's acetaminophen, priced at $3.49 for 100 ml, a 15 ml dose costs 52 cents - more than triple the price of a brand name adult dose.
 

A few years ago, Triaminic halved the amount of medication in children's cold medicines, increased the recommended dose from one teaspoon to two, and kept the price the same

  Moving right along to cough and cold remedies, we find that Benylin Nighttime for adults costs $5.59 for 85 ml. Benylin Bedtime for children costs exactly the same price for the same size - $5.59 for 85 ml - BUT contains exactly one half (15 mg per five ml) the dose of active ingredient as the adult mixture (30 mg per five ml).
  Triaminic epitomizes clever marketing for children. A few years ago, Triaminic halved the amount of medication in children's cold medicines, increased the recommended dose from one teaspoon to two, and kept the price the same. More recently, Triaminic started advertising "tailored" cold remedies. In other words, they've removed active ingredients from some products and continue to market them at the same price. The cough remedy has barely minimal decongestant, for instance, and vice-versa. Each bottle costs about six dollars for 100 ml. Want a combination of decongestant plus cough relief? If you stick to Triaminic, you'll have to buy two different bottles, and take both.
  Cold remedies don't have to be complicated. Dimetapp sells one large bottle (250 ml) of cold syrup for $10.29 for everybody in the family. Young children take one teaspoon or less; adults take four teaspoons.
  So what's a parent to do? Health Canada dosage guidelines stipulate that for acetaminophen and ibuprofen, children from six to eight may take the adult dose safely, although they should take fewer doses per day than adults would. Health Canada advises against giving pills or tablets to children younger than two, but mainly because youngsters might swallow the wrong way and aspirate, or get the pill stuck in the wrong windpipe.
  Beyond the expense of paying more per dose for children's medicine than for adults, there's the sheer frustration of trying to compare prices from the labels. Following directions on the label of Motrin liquid would involve giving a 10-year-old child a larger dose than an adult would get (two teaspoons, or 250 mg) at a cost of about 90 cents. The well-meaning parent would not only waste money, but also possibly create an extra risk for a sick child.
  In the US, the Food and Drug Administration announced an initiative in April 1999 that will require standardized label formats on all OTC drugs sold at retail outlets. The FDA expects 75 per cent of labels to comply by 2002,and 95 per cent by 2006. Health Canada has been discussing a similar initiative since 1992, but as yet, no standards are in place. Indeed, the references to "labelling" on Health Canada's website all involve food labels.
  Nobody, anywhere, seems to be addressing the question of truth-in-advertising for labels on painkillers and cold remedies marketed especially for children. Parents who want value for their money are not bad parents, they're smart consumers. But what does that make the drug companies who try to take advantage of parents' anxieties?

Penney Kome is an award-winning journalist and author based in Calgary.

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