The World Health Organization (WHO) launched the Better Medicines for Children (BMC) initiative which promotes the development of child-friendly medications in 2007. The BMC addresses the need to improve medication formulations and focus on making medicines that are suitable for children. In a 2015 report by the Pan American Health Organization, approximately 1000 children die every hour globally. Evidence suggest that 50% of death among children below five (5) years of age are caused by diseases for which medicines existed but not accessible to children.
For example, two of the major causes of these deaths are diarrhoeal diseases (which account for 17 percent of the deaths) and pneumonia (which also account for 17 percent). Both diseases are easily treatable, but current medications are formulated for adults and not available in doses suitable for children. Health practitioners are compelled to prescribe medications based on adult pill formulations. The World Health Assembly stressed the need to develop child size dosages of necessary medications to improve access for children.
Prescriptions based on guesswork
In the absence of child size doses, health care professionals and parents have to approximate the correct dosage for children by crushing and chopping adult pills. This method of preparing makeshift prescriptions involves a lot of guesswork, which is not only ineffective but also risky.
In a 2015 update, Dr Hans Hogerzeil, Director of Essential Medicines and Pharmaceutical Policies of the WHO reported that while some progress has been made in this area, many medications are still given to children without the proper testing and regulation. Hogerzeil stressed that children are not just little adults. therefore, providing proper medication involves more than just adjusting the dosage. Proper testing that involves a study of how children’s bodies metabolise drugs is required to ensure safety and efficacy of medications.
High cost of medications
One challenge in the implementation of child-friendly medications is the cost. Some pharmaceutical companies are taking advantage of the situation by setting high prices for child-friendly medicines. These medications are usually just liquid formulations of drugs that are already available in the market, but the cost is exponentially higher.
In the United States, the Pediatric Research Equity Act, which requires more companies to have pediatric-focused drugs clinically assessed in kids, and the Best Pharmaceuticals for Children Act, which delays the approval of competing generics if they are tested on children has allowed some companies to enjoy exclusivity for a few months. The lack of available competition enabled them to raise the price point at the expense of consumers.
How expensive are these medicines? In a letter published in the New England Journal of Medicine, Luke Probst and Thomas Welch of upstate Golisano Children’s Hospital in New York estimated that liquid form of Qbrelis is 775 times more expensive than the generic tablet and the cost of enalapril liquid product is 21 times more than its tablet counterpart. Pharmaceutical companies associate the high cost to the additional testing and ensuring the medicines’ safety and efficacy in their liquid state.
The very high cost of compound medications causes additional stress to parents, who are already burdened by their children’s disease and other hospital expenses.
A better option
Technology like myLiquitab could play a significant role in addressing the challenge posed by lack of child size medications. myLiquitab can help improve the current challenge of crushing pills by transforming the tablet to an easy to swallow liquid.
More importantly, myLiquitab offers an alternative long-term solution to the formulation of child medications. Instead of formulating compound medications, pharmaceutical companies can develop children’s medicines in their more stable and cost effective tablet form. Using myLiquitab technology, parents then have the option to liquefy the tablets for their children who cannot take the medication in pill form.