Stories about: John Lee

CVS offers low-cost version of EpiPen; experts say more options expected

PharmacyFor 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.

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The Auvi-Q recall: What your patients need to know

Auvi-Q food allergySanofi 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.

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Should providers rethink how they test a child for a food allergy?

skin prick test food allergy
(NIH/Wikimedia Commons)

A food allergy diagnosis can save a life, but comes with its share of hardships. Apart from the costs associated with food avoidance and medical care, children with food allergies (and their families) can face stress, anxiety and a sense of social isolation. John Lee, MD, director of Boston Children’s Hospital’s Food Allergy Program, recently told Scientific American (SciAm) that:

“Food allergies can be terribly isolating for a kid. One parent told me his child was forced to sit all alone on a stage during lunch period. And siblings can feel resentful because in many cases parents don’t feel they can take family vacations or even eat dinner in a restaurant.”

The problem here isn’t food allergies themselves, but the diagnostic tests we use. As SciAm reports, the standard skin prick test can have a 50 to 60 percent false-positive rate, labeling many children as food allergic who actually aren’t.

One answer: Use a better food allergy test. Lee advocates for placebo-controlled testing. While these tests are more resource intensive, he tells SciAm that they are also much more accurate:

A potential irritant is eaten, and the body’s response (a rash, say, or swelling) is compared with what happens after eating something that looks like the irritant but is benign. For example, a patient who might be allergic to eggs is given a tiny amount of egg baked into a cake, along with a taste of egg-free cake. Ideally, the test is double-blind, meaning that neither the patient nor the allergist knows which cake contains egg. The accuracy rate of these tests, for both positive and negative results, is about 95 percent, according to Lee.

Read more about problems with food allergy testing in Scientific American.


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Can peanut allergy be prevented?

peanuts peanut allergy preventionOn Boston Children’s Hospital’s Thriving blog, allergist John Lee, MD, clinical director of the hospital’s Food Allergy Program, responds to a worried parent’s question about whether it’s possible to keep her baby from developing a peanut allergy.

He cites the recently-published Learning Early About Peanut Allergy (LEAP) study, which compared the effects of peanut consumption and avoidance strategies in children at risk for developing a peanut allergy.

“The results of this study were more successful than anyone had ever thought they would be,” Lee says, “and are changing how we approach prevention of food allergies.”

Read the full story on Thriving.

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