STEVE INSKEEP, HOST:
Anybody who has a kid with a fever makes a discovery at the drugstore. There are two options for Tylenol - one for infants, one for children. They contain the same amount of medicine, but the infant version costs three times more. Why would that be? Here's NPR's Selena Simmons-Duffin.
SELENA SIMMONS-DUFFIN, BYLINE: Turns out there's a backstory. For a long time, Infants' Tylenol was stronger than the children's stuff.
INMA HERNANDEZ: It was three times more concentrated.
SIMMONS-DUFFIN: That's Inma Hernandez of the University of Pittsburgh School of Pharmacy. The thinking was you don't want to give little babies lots of liquid medicine, and you can give them less if it's stronger, hence the cost difference.
HERNANDEZ: The price per milliliter was five times higher.
SIMMONS-DUFFIN: But there was a problem. Parents were making mistakes with dosing. Babies got sick, and some even died. So at the urging of the Food and Drug Administration in 2011, Johnson & Johnson announced a change.
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UNIDENTIFIED NARRATOR: Infant's Tylenol is now offered in the same concentration as Children's Tylenol.
SIMMONS-DUFFIN: But the price is still different. With store brands of acetaminophen, it's the same story. The infant version is generally three times more than the one for children. I asked Johnson & Johnson, the maker of brand-name Tylenol, why. The company says the infant version comes in a sturdier bottle and has a syringe for accurate dosing. The children's version only has a little plastic cup. Inma Hernandez isn't convinced by that. She says what's expensive in producing a drug like this is the active ingredient, not a piece of plastic.
HERNANDEZ: The cap versus the syringe doesn't really explain the price difference, in my opinion.
SIMMONS-DUFFIN: But Johnson & Johnson's explanation makes sense to Edgar Dworsky. He's a consumer advocate and founder of the website Consumer World.
EDGAR DWORSKY: There's an extra thing in the box, and extra things usually cost money.
SIMMONS-DUFFIN: He says there's a convenience element here.
DWORSKY: Think of, you know, a spray cleaner. You can buy the spray cleaner in the spray bottle, and that costs little more money. Or you can buy the refill that gives you more ounces, but it doesn't have the sprayer on top. It's kind of the same concept.
SIMMONS-DUFFIN: But this, of course, is not a spray cleaner. It's medicine for your baby. Parents can be sensitive to marketing because the stakes are so high. Dr. Ankoor Shah at Children's National in Washington, D.C., says when it comes to infant and children's acetaminophen, the most important thing is to get the dosing right.
ANKOOR SHAH: When you start giving more than recommended, there are serious side effects that could happen.
SIMMONS-DUFFIN: So the bottom line, know what you need. If spending that extra couple of dollars for the syringe will help you get the dosing just right, maybe the markup is worth it.
Selena Simmons-Duffin, NPR News.
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