By Brianna Bell
An epinephrine injector is a vital medication for anyone with a severe allergy that causes an anaphylactic reaction—but access to this medication can be limited and expensive.
Epinephrine injectors, like the popular EpiPen brand, are an important product that administers the medication epinephrine through an auto-injector. The organization Kids with Food Allergies say that common allergens include foods, medicines, insect bites, and latex, and anyone who has experienced a severe allergic reaction should seek immediate medical attention.
Adults and children with severe allergies should carry an epinephrine injector with them at all times, but with recent shortages, access has been limited.
Pfizer, manufacturer of the EpiPen brand, has updated their supply statement to indicate that they are still experiencing manufacturing challenges. The reasons for the limited supply have not been specifically addressed, however, Pfizer said in their statement that their manufacturing partner, Meridian Medical Technologies is experiencing “manufacturing challenges.”
Since it began in May 2018, The Food Allergy Research and Education (FARE) have been updating the public on the epinephrine auto-injectors shortage. A June 2019 update indicates that the shortage continues, and that the FDA and Pfizer have coordinated to extend the expiration date on EpiPens and Pfizer’s authorized generic version by an additional four months—but EpiPen Jr is not included in the expiry date extension. In the meantime, FARE is recommending that patients who are unable to access their typical epinephrine auto-injector brand, request that their doctor prescribe alternative brands that are FDA-approved.
As of 2018, the FDA approved a few alternatives to the EpiPen. These new approvals provide consumers with alternatives, at a variety of different price points. FamilyWize has created a helpful list of products available. Also note, pricing on these products varies from pharmacy to pharmacy, but using the FamilyWize discount card to purchase these products could help bring down the cost significantly.
Kaléo-owned Auvi-Q offers the only FDA-approved epinephrine auto-injector for infants and toddlers. The unique 0.1 mg dosage is designed for children weighing 16.5 to 33 pounds. The Auvi-Q is also available in dosages of 0.15 mg and 0.3 mg.
EpiPen and EpiPen Jr.
Pfizer and Mylan owned EpiPen brand is the most-prescribed epinephrine auto-injector on the market. EpiPens are currently experiencing a shortage, and the FDA has approved an additional four month extension on the package expiry date (as of June 2019). EpiPen Jr. is available as a 0.15 mg dosage of epinephrine and is used for children weighing 33 to 66 pounds, but it is not included in the expiry date extension.
Authorized Generic (AG) for EpiPen
This FDA-approved authorized generic epinephrine auto-injector is available in a 0.3 mg dosage and 0.15 mg dosage, and is produced by Pfizer. It is therapeutically equivalent to EpiPen brand, but offers a discount of more than 50% (according to the EpiPen website). EpiPen’s authorized generic brand is also affected by the manufacturing shortage.
An alternative to EpiPen is Adrenaclick, an epinephrine auto-injector available in a 0.3 mg dosage, and a 0.15 mg dosage. FARE suggests Adrenaclick as an alternative if consumers cannot access their typical brand, and recommends patients ask their doctors to prescribe alternatives like Adrenaclick during the shortage.
Epinephrine Injection, generic Adrenaclick
Another recently approved generic version of a branded epinephrine auto-injector, Adrenaclick produces a lower cost generic version of their product, available in 0.15 mg and 0.3 mg. The website notes that the expiration date has been extended by two months on affected lots, due to a product shortage.
Teva offers their own generic FDA-approved equivalents to the EpiPen and EpiPen Jr., which provides another cost-effective option for an epinephrine auto-injector.
An FDA-approved prefilled epinephrine syringe, this product is not an auto-injector. SYMJEPI provides both a 0.3 mg ready-to-use syringe, and a recently approved 0.15 mg dosage. According to the SYMJEPI website, their product provides the lowest wholesale cost, compared to all currently available epinephrine auto-injectors.
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