As EpiPen prices soar, food allergy sufferers search for alternatives

August 19, 2016

As parents of children with food allergies begin gearing up for the start of school, many have faced a harsh reality as the price for the potentially lifesaving EpiPen has skyrocketed over the past few years.

EpiPens are spring-loaded syringes filled with epinephrine and are widely carried by people with life-threatening allergies. Over 3.6 million prescriptions for EpiPen kits were written last year, and another half-million for other similar products, a recent article states.

Once injected into the body, epinephrine can help reverse anaphylactic reactions. However, the prices of the auto-injectors that administer the epinephrine have soared — more than quintupling since 2004. Some retailers are now charging more than $700 for a set.

Along with the hike in price, the number of children with food allergies also continues to grow. Today, more than 6% of U.S. children have at least one food allergy, according to the U.S. Centers for Disease Control and Prevention.

According to data provided by Elsevier's Gold Standard Drug Database, the company that produces EpiPens has raised the list price more than 450% since 2004, after adjusting for inflation. The company said the price increases over time "reflect the multiple, important product features and the value the product provides."

And while there are some other competitors in the market, their products have yet to catch on or have been taken off the market due to problems with the devices dispensing inaccurate amounts of medication. Others have not been granted approval by the FDA, the article explains.

The high price for EpiPens has drawn public ire, and interest from lawmakers as well. It has also caused many emergency medical responders — and some regular families — to turn to manual syringes as a cheaper alternative.

This change is a raising concerns among some doctors and patient advocates, who warn that it's more complicated to get the correct dose and administer it safely with a syringe.

"Anyone using this approach would require extensive medical training to do it effectively and safely, without contamination or accidental intravenous injection," Dr. James Baker, Jr., the CEO and chief medical officer of Food Allergy Research & Education, said in the article.

However, some parents are left with few alternatives. In one example, Amie Vialet De Montbel, a mother whose 15-year-old son has a severe milk allergy, said she can buy a couple of glass ampules of epinephrine and regular syringes from a local pharmacy for a fraction of the cost — about $20.

Emergency medical providers have also been talking about the rising cost of EpiPens for the past few years. "The price of the auto-injector has become a real issue, particularly for the small rural agencies," said Dr. Peter Taillac, chair of the medical director’s council of the National Association of State EMS Officials.

The high cost has driven officials in at least 10 states — including Colorado, Maryland, and South Carolina — to push for training more EMTs to give epinephrine injections using regular syringes.

In fact, first responders in Seattle have developed a kit in place of EpiPens to save money. King County EMS began using the kits, which contain instructions, an epinephrine vial, and a syringe, in 2013. By now, they've replaced about 950 of their 1,000 EpiPens with the kits, according to Jim Duren, professional standards manager for King County EMS.

Duren said that in the first year, his county saved more than $150,000. In New York, a pilot program with similar kits is estimated to save more than $1 million, if implemented statewide, Dr. Jeremy Cushman, one of the program's leaders said.

However, the Asthma and Allergy Foundation of America finds this trend troubling and recommends that everyone — parents, patients, and emergency responders — use epinephrine auto-injectors, not regular syringes.

"It's fast, you don't need to think, [and] it provides a measured dose," Dr. Cary Sennett, president and CEO of the foundation, said in the article.

But Dr. Richard Lockey, a professor at the University of South Florida said as long as patients are educated about how to use the syringes, they're "99% as good" as the EpiPens. "Is that ideal? Well, no, not necessarily," he added. "It's better to have an auto-injector, yes."

But Lockey said syringes make sense for patients who can't afford the EpiPen. "Everyone wants to drive around in a Cadillac," he said, “but not everybody does."

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Category: Food Safety, Food & Beverage, Allergens