As EpiPen Prices Skyrocket, Nurses Suggesting Patients Use Syringes

[DoGoodThenGo]

Media and now Congress has finally latched onto something many in healthcare have known for quite sometime; EpiPen prices have skyrocketed to $600 from $100 over the past eight years. Families/persons who need these autoinjectors are quite angry because not all can afford the increased rates and worry about being priced out of having access to life saving medication.

According to news reports some nurses and other healthcare professionals are advising patients and or their parents/caregivers to use syringes to inject epinephrine instead. One horrified mother interviewed for local evening news was literally near tears saying she "never could do that" when advised by a nurse who was part of her daughter's medical team. Many EMS personnel have long gone back to syringes as a cost saving measure with the prices of EpiPens putting a strain on budgets.

[BCgradnurse, MSN, RN, NP]

While carrying a vial of epi and a syringe seems easy, I agree it's not a great idea for the general public. Anaphylaxis can come on fast and I know some panicked parents and patients who even have some trouble with the auto-injector in a crisis. I have started prescribing the generic as most insurances cover it fully or for a small co-payment. Mylan has given me Epi-pen samples for those who truly cannot afford it, and I give those out judiciously. I think both insurance companies an Mylan should be ashamed of themselves. Mylan for jacking up the price and insurance companies for offering poor coverage for this medication. I have a child with severe food allergies and I know how quickly he can go from being fine to losing his airway. There's no time to draw up medication.

[DoGoodThenGo]

Does anyone remember the "bee sting kits" from the 80s? Little red plastic box? I carried one because I am allergic to bees. It had diphenhydramine tablets, a syringe, a needle, and a vial of epi. Plus some alcohol swabs. I wish I could find a picture of it! I almost got in trouble for carrying it in school until they realized what it was (or what it wasn't, lol).

You mean one of these?

[Lunah, MSN, RN]

You mean one of these?

Yes!!! Though I think I was confusing this with the glucagon kit my diabetic ex had with it having separate vials — the epi kit is pre-filled, obviously. I had thought about the tourniquet in there too — was just thinking about that a little while ago and wondering if I was mis-remembering. lol. Thank you for finding that, I was all over Google images with no luck. :)

[Lunah, MSN, RN]

Found a really good picture of it:

I remember that it had two doses in the syringe, but you had to give the plunger a quarter turn to access the next dose. Turns out it was first released in the 1970s: Legacy | HollisterStier Allergy

I also found this image, which totally appeals to my inner (outer) goth:

[DoGoodThenGo]

Yes!!! Though I think I was confusing this with the glucagon kit my diabetic ex had with it having separate vials — the epi kit is pre-filled, obviously. I had thought about the tourniquet in there too — was just thinking about that a little while ago and wondering if I was mis-remembering. lol. Thank you for finding that, I was all over Google images with no luck. :)

YW! T'wern't nothing. Took me just a few seconds to sniff it out.

What can one say, an education in what seems another era now (when we actually had to use books to find reference), and later a series of mind numbing office jobs have left me with a pretty good research skill set. *LOL*

[Mom2boysRN]

One other reason this is not a viable option is that children aren't always with their parents. My son is old enough he is out with his friends, with his coach, or other lay people. I could handle drawing up epi, but I guarentee his football coach wouldn't want that responsibility, and no offense to him, but I wouldn't want him to do it either.

Next time I need epi pens for my son I will look into the adrenaclick, the old style of epi pen had a needle that stayed out and as someone else mentioned after administration I bent back the needle and put it back into the hard plastic sleeve it came in.

Having easy to administer epinephrine is of utmost importance, because if it isn't given quickly that person that needs it could be dead.

[blondy2061h, MSN, RN]

I don't think you can compare drawing up insulin with drawing up epi.

Insulin is given in a calm, non-stressful environment.

Epi is given in an emergent, stressful situation where seconds matter. That is a the beauty of the epi-pen. It's a grab and give device.

Also, diabetics use insulin multiple times a day, so they're well practiced at it. People may need epi once in several years.

[BuckyBadgerRN, ASN, RN]

It's supposed to be painful so your body releases the natural response to pain to help with the reaction

There are Canadian online pharmacies and generic AdrenalClick for $100- 140. Although I totally agree that people in Mylan Pharma lost their last shreds of shame long ago but looks like this time they have to come back to harsh reality.

I would be more concerned about dosing if using syringe and needle. Adrenaline standard amp used for code is 1 mg, which is 3.3 doses for standard Epipen. That's a lot of adrenaline, and this drug, while very effective, is not exactly "safe" one. Personally, I would prefer it this way as long as I draw med myself or by EMT staffer. Epipen is excruciatingly painful shot.

[DoGoodThenGo]

Victory of sorts!

Mylan announced today it will produce an authorized generic version of EpiPen that will sell for $300 in a few weeks.

[KatieMI, BSN, MSN, RN]

It's supposed to be painful so your body releases the natural response to pain to help with the reaction

If it were so, Epipen wouldn't be needed and a good kick under one's behind would suffice. If anaphylaxis develops, the organism goes into super-uber-panic mode immediately, just like it responds on severe pain; the problem is, adrenals can only release an equivalent of 0.1 mg of adrenaline at a point, not enough to support vital functions during developing shock.

One EMT guy once told me that he personally preferred to do "field intubations" on patients not completely sedated and paralyzed because, according to him, gagging moved larynx anteriorly and up and made it easily seen, and pain "would support blood pressure". I honestly wished him to be so treated, just once.

[SurgicalTechCST]

I need to fix that link.It was an article in the LA Times about how the FDA can fix the problem.

Mylan to launch a cheaper, generic version of EpiPen - LA Times

Here's some new information as of yesterday afternoon....

[SurgicalTechCST]

I tried to suggest in a mommy blog drawing it up, to a very negative response.

Heres the thing, even if you aren't comfortable drawing, learn. People need to hit Mylan in their wallet. Something nobody is willing to do.

Bit?$#*! On the Internet does nothing. Taking actual action and hitting them where it hurts, does. This would force them to lower prices and make the convenient pen affordable. After all, what did people do before the pen??? Lol. Draw it up.

I won't even go into why people are so resistant to this idea. After all, I'm sure C thousands, if not millions were saved by drawing up meds. But the unwillingness to even think outside of the box bewilders me.

I bet if Mom had to draw up and give insulin shots to her kiddies, or even herself, then she'd not be nearly as squeamish. Talk about life saving injection there.....But, in the face of a crisis, a lot of us do things we never thought we could.