6320 Do over-the-counter liquid medicines for children cost more than tablets?

Objectives This study compared costs of different formulations of over-the-counter (OTC) analgesics and antihistamines designed for children from 2 years of age. There is a misconception that children are unable to swallow tablets. Consequently, oral liquid formulations are favoured for children, despite several disadvantages; liquids are bulky, may require refrigeration, be unpalatable and require additional equipment to measure and administer doses accurately. There is increasing interest in supporting children to swallow tablets to reduce cost and make more medicines accessible.¹ Work to date has focused on children with long-term medical conditions.¹ ² We aimed to identify whether OTC liquid formulations are more expensive than tablets and determine whether community-based 'Pill School' programmes could help to reduce costs for families. Methods Researcher (MDC) visited two supermarkets, a pharmacy department store and two discount warehouses on 29/09/2023. Two analgesic drugs were included; Ibuprofen and Paracetamol and two antihistamines; Loratadine and Cetirizine. Formulations available, pack size and licensed age group were noted with the corresponding price. Price differences between own brand and branded OTC medication were assessed. Prices were standardised to allow comparison of cost per unit dose. Results A substantial difference was found between liquid and tablet formulations of these OTC products (table 1). Brand leader liquid costs were 2–3 times that of tablets and own brand liquids were 3–7 times more expensive than that of own brand tablets. 38% of tablet formulations assessed were not licensed for children under 12 years (figure 1). Conclusion A substantial price gap between liquid and tablet formulations was identified across all medications, with price differences up to 7-fold suggesting a potential economic burden associated with use of OTC liquid medicines. This could exacerbate healthcare inequalities and limit medication accessibility for families on reduced incomes. Parents buying OTC medications should follow the packaging instructions and only purchase those licensed for their child's age. The effectiveness of a 'Pill School' programme in younger children for OTC medicines, may be limited by the lack of licensed products available. The KidzMed training programme was developed to teach children how to swallow tablets.¹ Rowley et al. demonstrated that children as young as three were successful in swallowing tablets after completing the training program.² The findings highlight the potential benefits of implementing KidzMed programme in the community setting and enhancing awareness of the availability of OTC tablets licensed for children. Providing more options to children could improve child and carer satisfaction and offer economic benefits to families. References Tse Y, Vasey N, Dua D, et al. The KidzMed project: teaching children to swallow tablet medication. Archives of Disease in Childhood 2020;105:1105–1107. Rowley R, Berry C, Woodland C, Dale C, Mayell S. P052 Introduction of an innovative 'pill-swallowing school' in a cystic fibrosis paediatric population within a tertiary centre. Journal of Cystic Fibrosis21:S75-S76. doi: 10.1016/S1569-1993(22)00385-X.