For families managing life-threatening allergies, access to auto-injectable epinephrine — the medication that reverses the harmful effects of anaphylaxis, is critical.
But the price tag for the go-to prescription, EpiPen, a product manufactured by Pennsylvania-based Mylan, Inc., has skyrocketed in recent years, hitting a record high of $649 for a two-pack. The spike has outraged parents and pediatricians, and in some cases, stunted access for those with no insurance or high-deductible plans.
But the epinephrine auto-injector landscape is starting to shift.
Peanut and food allergies can be stressful for parents and patients. The skyrocketing EpiPen price tag has outraged parents and pediatricians, and many families may be unsure about their options. John Lee, MD, clinical director of the Food Allergy Program at Boston Children’s Hospital, shares his insights on the EpiPen price increase and and offers updates on peanut allergy research.
What you need to know about EpiPen now
- EpiPen recently raised its commercial price to $600 for a standard twin pack. For families with no insurance or high-deductible plans, this can pose some serious challenges. However, the good news is there are a few strategies for lowering the cost.
- Parents can go to Epipen.com, and download a free, reusable, discount card for up to $300 off a prescription.
- Mylan, EpiPen’s parent company, has an EpiPen assistance program for families with incomes up to four times above the poverty line.
- Adrenaclick is an alternatives to EpiPen. Although it has the same epinephrine doses as EpiPen, the mechanism is slightly different. Most school nurses and staff are not trained on Adrenaclick, so it is important to talk to a child’s school nurse before choosing this option.
- EpiPen has announced it will release a generic model at half the current retail price sometime this fall.
- New instructions
I always remind parents to make sure there are unexpired EpiPens with their child’s name at school. Schools typically ask for two injectors that won’t expire during the school year (EpiPens last about one year).
Parents should also review their child’s Anaphylaxis Action Plan, and be sure to understand the written plan they give to the school.
- EpiPen recently updated its instructions, because there were numerous reports of kids suffering lacerations in their legs. It’s important for parents to note the changes.
- Step 1: Stabilize the patient’s leg to minimize movement.
- Step 2: Hold the EpiPen against the thigh for three seconds.
- Step 3: Monitor for signs of infection at the injection site.
A study last week in The New England Journal of Medicine suggests that exposing infants to peanuts can provide lasting protection against peanut allergy. But what about peanut-allergic children right now? They and their parents live a life of precautions — from pre-screening birthday party menus to segregation at the school lunch table — to avoid life-threatening consumption of even trace amounts of peanut.
Now, a multi-center study reports on a protocol combining the allergy medication omalizumab (Xolair) with controlled, gradually increasing peanut consumption. After 20 weeks, most initially allergic children could safely consume the equivalent of 8 to 10 peanuts at a time. Three months after stopping the medication, most had worked up to 16 to 20 peanuts.
The small boost in peanut tolerance may not seem like much, but it could mean less worry for parents who are constantly on guard for even trace amounts of the substance. Our sister blog, Vector, has more of the story.
Learn more about peanut allergy research on Vector
Sanofi has issued a voluntary recall of its Auvi-Q epinephrine injectors over concerns about inaccurate dosing. If you see patients who use the Auvi-Q, they should seek out an alternative injector for the time being.
Our sister blog Thriving spoke with John Lee, MD, director of the Food Allergy Program at Boston Children’s, about what families should should do about the recall:
Contact your child’s doctor immediately for a replacement injector from another brand. Parents need to contact a physician for a new prescription; you cannot go to the pharmacy to buy an epinephrine injector without a prescription.
Do NOT dispose of Auvi-Q injectors until you have a replacement. If your child experiences an emergency or goes into anaphylaxis and an Auvi-Q is the only option available, you should use it.
Finally, save any receipts and pharmacy documentation, because Sanofi is reimbursing its customers for the cost of replacement injectors.
Lee offers additional advice on Thriving.