Alberta Premier Danielle Smith and Minister of Health Jason Copping address the children’s medication shortage in Edmonton, on Dec. 6, 2022.JASON FRANSON/The Canadian Press
Alberta purchased children’s pain medication from Turkey at a price more than six times greater than what the provincial health authority normally pays for the same volume of product, according to documents obtained by The Globe and Mail.
The Alberta government explained in 2022 that the manufacturer required a minimum order of five million bottles – or $70-million worth of drugs – to get the deal done. But a briefing note, obtained by The Globe, indicates the health authority could have reduced its total bill by ordering less medicine, albeit at a higher price per bottle.
Five million bottles equated to roughly eight bottles for every child in the province.
Alberta Premier Danielle Smith has long defended the importation plan, arguing her government took action to alleviate a critical shortage of over-the-counter children’s drugs caused by an exceptional spike in respiratory illnesses that fall. Edmonton’s MHCare Medical Corp. facilitated the deal, which is now subject to multiple investigations, including separate examinations by the RCMP and Alberta‘s Auditor-General. The health authority’s former chief executive alleges in a lawsuit that government officials interfered in the contract and procurement process at her organization to the benefit of private companies.
David Postel, a lawyer for MHCare, on Thursday said it is “profoundly unfair” to compare the price his client billed for the medication from Turkey to the health authority’s typical costs, which he said reflect pre-pandemic pricing.
“The whole reason for procuring from MHCare was that there was an acute continent-wide shortage,” Mr. Postel said in a statement. “The prices set by AHS were determined when supplies were scarce and demand had skyrocketed.”
Bureaucrats in government and at the health authority prepared briefing notes in late 2022 outlining the risks and rationale for paying MHCare to import pediatric acetaminophen and ibuprofen from Turkey’s Atabay Pharmaceuticals. They laid out several options for the government, warning that if the government chose the riskiest path – signing a deal to buy five million bottles of medicine prior to receiving Health Canada’s approval – it could end up with too much medicine, too late, or it could end up with little to no medicine despite paying upfront if they didn’t get the approval.
Stores in North America were short on supply at the time, and the health authority’s usual vendors were unable to fill the void.
The briefing note says that because of Canadian requirements for packaging and bilingual labelling, the manufacturer indicated a minimum order of five million bottles to cover production changes.
However, the note also says the province could order fewer bottles at a price of $15-million for one million bottles. The note says committing to a larger volume would represent “the best overall value.”
MHCare delivered 1.47 million bottles of medicine to Alberta in the first half of 2023. The company, in a letter sent to the province in April, 2025, noted Health Canada did not provide the necessary approvals to import all five million bottles.
Only a fraction of the medicine, most of which arrived after the shortage had eased, was ever distributed to hospitals and pharmacies. In May of 2023, health officials ordered staff to stop using the imported acetaminophen in neonatal intensive care units after deeming it a risk to patients when administered through feeding tubes. Within two months, there was a hospital-wide transition back to using standard children’s medications.
AHS’s former CEO, Athana Mentzelopoulos, in a lawsuit filed in February alleges the government fired her for investigating the Turkish deal, along with other contracts and procurement agreements at the health agency. The government alleges she was fired for incompetence. The allegations have not been tested in court.
When Alberta announced the import deal in December, 2022, it said it was paying a small premium over the expected retail price for the drugs. But the briefing document and a price sheet from MHCare reveal, for the first time, how much the health authority paid compared with what it typically spent on the same drugs.
The note calculates AHS’s annual bill for the pediatric pain relievers used in hospitals.
AHS’s “usual confidential contract price” for the liquid acetaminophen and ibuprofen pediatric patients consume each year equates to about $450,000, the briefing note says. The same volume of product would cost $3-million, or 6.7 times what the health authority pays its usual vendors, should MHCare import bottles of medication at $14 each, the document estimates.
But the medication produced by AHS’s normal vendors is not comparable to the Turkish supply. Some of the medicine in Atabay’s bottles was less concentrated, meaning patients need to consume more volume to get the same amount of drugs. When accounting for the difference in concentrations, the price difference between the normal supply and the imported medicine expands significantly.
The Alberta government instructed the health agency, via a ministerial order dated Dec. 1, 2022, to procure liquid oral acetaminophen and ibuprofen at specific concentrations to address the national shortage.
MHCare’s owner, Sam Mraiche, provided a price quote dated Dec. 5 to Jitendra Prasad, then the health authority’s interim chief program officer for contracting, procurement and supply management. Mr. Mraiche’s price quote detailed concentrations that differed from what was stipulated in the ministerial order.
Mr. Prasad was heralded for his work in procurement at the health authority during the COVID-19 pandemic and retired in April, 2022. He then worked as a consultant, before reprising his role in procurement at the health authority in October of that year.
According to allegations contained in Ms. Mentzelopoulos’s lawsuit, he had an MHCare e-mail account in November, 2022. The health authority and the government were exploring the import deal that same month. Mr. Prasad’s lawyer did not acknowledge messages seeking comment.
Ms. Smith is re-organizing Alberta Health Services, and as of last week had four ministers overseeing various aspects of the provincial care system. Kyle Warner, a spokesman for Matt Jones, who is in charge of the newly created Ministry of Hospital and Surgical Health Services, in a statement said Alberta Health Services conducted the contract and procurement negotiations for the children’s medication. He noted the contracts are now under review.
“The results of these reviews will support our work to improve procurement practices and will enable our government to address any other identified issues,” the statement said.