At Dayton Children’s, families have recently shared concerns with pediatricians about the rising prices of EpiPens.
“I have had families asking me if there are alternatives, especially for those who have higher deductible insurance plans,” says Dr. Maria Nanagas, medical director at the Children’s Health Clinic at Dayton Children’s. “Many of our families receive Medicaid, so the costs are passed on to government-sponsored insurance, too.”
What is an EpiPen?
An EpiPen is used to treat a severe allergic reaction. There are two versions of this patented auto-injection device that deliver different pre-measured doses of the drug epinephrine quickly and easily, even through clothing. Speed and ease are essential.
Why is it important?
A severe allergic reaction is also called anaphylaxis. Along with the typical allergic reactions of a rash or hives, symptoms of anaphylaxis include:
• Extreme trouble breathing
• Extremely low blood pressure
Epinephrine is adrenaline, a substance normally made in the body in response to stress, good or bad. If given during an allergic reaction, it can resolve those symptoms — relaxing muscles to improve breathing, constricting blood vessels and stimulating the heart to increase blood pressure, and helping reduce swelling.
“Anaphylaxis is one thing that scares me as a physician because despite all of our efforts, a child can still die,” says Thomas Krzmarzick, medical director of the emergency department at Dayton Children’s. “Immediate treatment with EpiPen is the single most important life saving therapy to treat anaphylaxis.”
Are there alternatives?
There are alternatives to the EpiPen, however each presents issues, like different injection devices. “Parents would need to make sure that everyone who cares for that child was properly trained on the different mechanism,” says Greg Huff, director of pharmacy at Dayton Children’s. “Using it incorrectly could result in not enough epinephrine delivered during the injection to help the child.”
EpiPen is so widely known and used, it has become somewhat a standard for care. “We use EpiPens in the emergency department because they are premeasured with the appropriate dose and can be administered even through fabric, saving precious moments of removing clothing,” says Pam Bucaro, RN, clinical nurse specialist at Dayton Children’s.
“Another alternative is a syringe and vial, however I don’t believe that is the best options for families in the middle of a crisis,” says Bucaro. “At a time when seconds matter, you are asking a frantic child, parent or teacher to use a syringe and vial, adequately measure the appropriate dose, then remove clothing to administer the shot directly in the thigh. The possibility for error is just too great.”
So what can parents do?
“The most important thing families can do to keep their child safe is avoid the allergen,” says Dr. Krzmarzick. “Make everyone aware of the dangers — from friends and family to teachers and baby sitters — so they can avoid it, too.
“The child should wear a medical ID bracelet that can alert anyone who may not know in an emergency. And despite the cost, an EpiPen is still the safest and fastest way to help your child during a severe allergic reaction. Families need to have them available at all times.”
Epi-Pen is expanding ways to help families. “To find savings, look on the EpiPen websites or social media for coupons or rebates,” says Huff. “Ask at the pharmacy where you get your prescription filled or your insurance company, if they have any coupons or discounts. These organizations may have ways to help you.”
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This look at a children’s health or safety issue comes from Dayton Children’s Hospital. Email: firstname.lastname@example.org.