So, granddaughter #2 turns out to have some fairly significant food allergies. Daughter goes to purchase prescribed EpiPens. Four of them. You must have 2 in order to give a second dose if EMS is slow to arrive. A daycare situation requires 2 more EpiPens.
Walmart Pharmacy calls to inform daughter that the charge for 4 pens is $1200. Daughter says "oh no, I have Aetna insurance." Pharmacy says "that figure includes Aetna's payment of (drumrolll, please) of $2.62." A discount card found on the internet takes another $200 off. Daughter is left to pay $1,000 for a drug she hopes she will never need and which expires in 10-12 months. One of my OR sources quotes the amount of epinephrine in 1 pen as having the base cost of $.03.
Turns out that the maker of EpiPen has a virtual corner on the market on adrenaline pens. Every year, they increase the price because, well, because they can. They have also been accused of artificially decreasing the expiration date in order to require an annual purchase. Making money hand over fist on the backs of sick babies and adults.
There is so much wrong with our healthcare delivery system.
I work in an allergy practice and we have coupons from Mylan that will cover the entire cost of up to 2 two packs of Epi-pens and are good for as many refills as needed for 1 year. We've had these coupons for the last 3 years. They are only valid for patients with commercial insurance, but Mylan is great about giving us samples so those who cannot afford the cost can get a pack.
Are these coupons not available nation wide?
That's the company that gave us the free epipens . . . with an Rx though. A law was passed here in CA mandating all schools had to have emergency epipens. That did not make physicians very happy and they fought it and put some caveats in the law. But it passed and we all had to scramble to find a physician to write the Rx.
Sorry if someone already said this, I have to leave and don't have time to read the whole thread. One of my jobs is in peds primary care. The issue is that epipen brand is not on your granddaughter's insurance formulary. Your daughter drew the short straw at the pharmacy and got someone incompetent or in a rush who didn't bother to tell her this or trouble-shoot it for her. There are two other options for epinephrine pens (in my region, anyway), and she should call the pharmacy and make them figure out which is on the formulary. She should:
1. Call the pharmacy and ask them to run, first, adrenaclick (junior if the granddaughter is under 30 kg, regular if she's over) -- they can run it before it's prescribed to see if the insurance covers it.
2. If adrenaclick is not in the formulary, have them run generic "epinephrine pen." If you get a crummy pharmacist that doesn't know what you're talking about, give them the NDC numbers to look it up. NDC# for regular epinephrine pen: 54505-0102-02, NDC# for junior epinephrine pen: 54505-0101-02.
3. After your daughter finds out which brand is in the formulary, call the prescriber and tell them to send that instead.
4. Find a better pharmacist in the future who will do this for you automatically when they discover the problem. They can contact the prescriber on their own to fix it when an out-of-formulary med is sent. The issue with these is that the manufacturers didn't do the extra process to make them legally generics for each other (even though they literally have exactly the same thing in them), so the pharmacist can't just substitute the generic. They have to contact the prescriber and get the rx switched, or at the very least tell the parents what to do.
This kinda sounds like "Poor people could afford medical care if they tried harder."
I have a $1,500 deductible, and that's on the GOOD plan my employer offers.
Actually it's not. what is being said is that if you are someone or have loved ones you know require epis, you're going to be wiser to pick an insurance plan that would cover it. And also wiser to look into social programs to help with payment should you not be able to afford it. No one is telling the OP to magically pull $2,000 out of thin air. That's how people like you who are looking at it that way are trying to paint it, but that's not true at all. I
went without health insurance (before Obamacare) for years because I couldn't afford it because my father, the bread winner of the house, died and there was no f'ing way we were paying for Cobra insurance. I know what it's like to have to make ends meet. That is why when friends invited me on skiing trips, camping, etc, I politely declined cause I knew if I got injured I wouldn't be able to afford it.
It's about being responsible. As someone else mentioned - ok, the school requires an epi that's not expired. well then buy one for the school, and save the 366 day old epi for personal use...
Specializes in Complex pedi to LTC/SA & now a manager.
I recently responded with a severe allergic reaction to a bee sting.
Had never had a problem before (and it had been many years since I had been stung).
I worked in Radiology for 21 years, watching for and treating contrast reactions.
I was surprised --- yes, SURPRISED -- how quickly my own reaction happened.
Within 20 seconds I felt strange and within a minute had huge welts.
I was camping with friends and took 50mg Benadryl my husband happened to have on hand.
He insisted I chew it.
I, as the nurse, did not.
I should have.
My pressure bottomed out within 3 minutes, so I laid down.
Friends (MD and EMT) observed me for an hour.
I felt my throat swelling but I knew I could still breathe so concentrated on being calm and trusting Benadryl to do what I had seen it do many times in Radiology.
(are we not incredibly stubborn??? )
When I was able to walk around without dizziness, after about an hour, I saw in the mirror my throat and face were quite edematous. I literally looked like Jabba the Hut.
I took another 50mg Benadryl in two more hours.
The next day I called my PMD to fax a prescription for an EpiPen, which I now carry.
I now counsel all who will listen to ALWAYS carry Benadryl (and perhaps Prilosec) with them, for we NEVER KNOW when we may react to a medication or food or whatever.
Off soap box, and returning you to your regular programming.
Prilosec is a PPI and will do nothing. You need a histamine 2 blocker which is ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet). Benadryl is a histamine-1 blocker.
Could you (for home use) get a vial and syringes and have a few doses pre-drawn up like we do in home care for diabetics without the dexterity to draw up their own? Could provide peace of mind.....
Prilosec is a PPI and will do nothing. You need a histamine 2 blocker which is ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet). Benadryl is a histamine-1 blocker.
You are responding to Dianah's story which I did as well. Again, I have to correct you on histamine-1 or 2 blockers. The standard of care for signs and symptoms of impending anaphylaxis is epinephrine. Histamine 1 or 2 blockers do not treat anaphylaxis. There is no down side to giving epi.
Epinephrine (adrenaline) is the first-line treatment for severe or life-threatening allergic reactions, known as anaphylaxis. It is available in an auto-injector ( Auvi-Q™, EpiPen® or Adrenaclick®). Epinephrine is a highly effective medication that can reverse severe symptoms. However, it must be given quickly to be most effective. Delayed use of epinephrine during an anaphylactic reaction can be deadly.
Epinephrine is a safe drug, with the risks of anaphylaxis outweighing any risks of administering the medication. Patients should proceed to the emergency room after epinephrine is administered in case additional medication or treatment is needed to manage the reaction, not because epinephrine is a dangerous drug.
Antihistamines, known as H1 blockers, are prescribed to relieve mild allergy symptoms (e.g., itching, sneezing, hives and rashes), although they cannot stop or control a severe reaction. Medications in this class include diphendydramine (Benadryl®) and cetirizine (Zyrtec®).
Antihistamines do not treat anaphylaxis and have no life-saving capacity – if an anaphylactic reaction is occurring, give epinephrine immediately and call 911.
This incident happened near me. It started up the conversation that epinephrine needs to be given right away. NO waiting. (The comments after are good as well even with one naysayer who is then shown the truth).
That's how people like you who are looking at it that way are trying to paint it
I know I'm in for a pleasant discussion when I read sentences like this.
I looked at the rates and benefits for "Obamacare" plans on my state's website during a time when I needed coverage. Combined premiums, deductibles, and OOP maximums could still drain me $10,000 a year for an individual.
You are responding to Dianah's story which I did as well. Again, I have to correct you on histamine-1 or 2 blockers. The standard of care for signs and symptoms of impending anaphylaxis is epinephrine. Histamine 1 or 2 blockers do not treat anaphylaxis. There is no down side to giving epi.
My impression wasn't that anyone was proposing H1 & H2 blockers as an alternative to epi? If I knew that a child or myself had anaphylactic reactions, I'd sure keep an auto injector pen on me at all times (not sure how I'd draw from a vial if I were alone an having an allergic reaction), but as a person with a history of unknown sensitivities (but nothing remotely resembling anaphylaxis so far, knock wood), it would be a cheap and easy thing to keep a few tablets of Benadryl & Zantac stuffed in my purse, for a "just in case."
Specializes in RETIRED Cath Lab/Cardiology/Radiology.
You are responding to Dianah's story which I did as well. Again, I have to correct you on histamine-1 or 2 blockers. The standard of care for signs and symptoms of impending anaphylaxis is epinephrine. Histamine 1 or 2 blockers do not treat anaphylaxis. There is no down side to giving epi.
This incident happened near me. It started up the conversation that epinephrine needs to be given right away. NO waiting. (The comments after are good as well even with one naysayer who is then shown the truth).
I did not mean to equate Benadryl with the effects of epinephrine, and I also erred in naming Prilosec to be taken.
If one HAS NO epi-pen and suspects new onset of unexpected allergic reaction, immediate taking (chewing) of H-1 and H-2 blockers can only help, in view of oncoming unknown reaction.
Of course, epinephrine, given asap, is the gold standard of care for known allergic reaction.
I did not mean to equate Benadryl with the effects of epinephrine, and I also erred in naming Prilosec to be taken.
If one HAS NO epi-pen and suspects new onset of unexpected allergic reaction, immediate taking (chewing) of H-1 and H-2 blockers can only help, in view of oncoming unknown reaction.
Of course, epinephrine, given asap, is the gold standard of care for known allergic reaction.
:) :) Carry on. :) :)
I know. I still have school-nurse-brain and I trained folks for the use of epipens with anaphylaxis.
There has been a tendency for a long time to wait to give epi and to give diphenhydramine instead. I just wanted to point out that is not the way to go.
If of course you are out in the boon-toolies and only have a histamine blocker . . . then by all means take it and call 911. The histamine blocker won't work though.
Prilosec is a PPI and will do nothing. You need a histamine 2 blocker which is ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet). Benadryl is a histamine-1 blocker.
My impression wasn't that anyone was proposing H1 & H2 blockers as an alternative to epi? If I knew that a child or myself had anaphylactic reactions, I'd sure keep an auto injector pen on me at all times (not sure how I'd draw from a vial if I were alone an having an allergic reaction), but as a person with a history of unknown sensitivities (but nothing remotely resembling anaphylaxis so far, knock wood), it would be a cheap and easy thing to keep a few tablets of Benadryl & Zantac stuffed in my purse, for a "just in case."
Beachynurse was responding to Dianah's story about her experience and to keeping Benadryl on her at all times. But histamine blockers do not work on anaphylaxis. That's what I was responding to when I made my comment.
The histamine blocker won't work though.
Spidey's mom, ADN, BSN, RN
11,305 Posts
That's the company that gave us the free epipens . . . with an Rx though. A law was passed here in CA mandating all schools had to have emergency epipens. That did not make physicians very happy and they fought it and put some caveats in the law. But it passed and we all had to scramble to find a physician to write the Rx.
Here is the law:
Bill Text - SB-1266 Pupil health: epinephrine auto-injectors.
I found the video!!
"If you are in doubt, always give the shot!"