Ohio health network suggests EpiPen alternatives

Opponents suggest training non-medical personnel to use a vial and syringe to inject epinephrine could be risky

By Kara Driscoll
Dayton Daily News

SPRINGFIELD, Ohio — Local doctors are recommending alternatives to EpiPens as the manufacturer of the device used to control allergic reactions scrambles to appease irate consumers.

The company that manufacturers the devices, Mylan, has a monopoly on EpiPens and has hiked prices as frequently as three times a year since 2007.

Local doctors are offering alternatives for families who cannot afford to pay up to $600 or more for the auto-injectors. Kettering Health Network, a local health care provider, offers an alternative it says is “just as effective.”

Dr. Marcus Romanello, chief medical officer for Fort Hamilton Hospital, said patients can get a vial of epinephrine at a pharmacy and store it in a small container. He said users still need to have a prescription to obtain the drug.

“I made one for under $10,” he said. “I put the vial in a small breath-freshener tin.”

The practice has been questioned by some medical experts, who say administering the drug with a vial and a syringe can be time-consuming — and often too stressful for someone under pressure during a medical emergency.

Beth Lizza, chief nursing officer at Ohio Valley Surgical Hospital in Springfield, said alternative treatments are “not as convenient” as the auto-injector.

“There’s always that concern during a high-anxiety moment,” she said. “It’s unfortunate that (the EpiPen) is so costly, because it is an easy product to use.”

Pam Bucaro, a clinical nurse specialist at Dayton Children’s Hospital, told this newspaper that it’s concerning to think that suspect alternatives might have to be used if someone can’t afford an EpiPen. Some doctors have raised additional concerns over the practice’s sterility and effectiveness.

“That’s pretty scary to expect someone to use a vial with a syringe,” Bucaro said.

Brandi Thacker of Carlisle said her 9-year-old daughter is allergic to peanuts and tree nuts and requires an EpiPen prescription. She said she paid more than $800 for three sets.

She looked for generic brands of the medicine, but found they were back-ordered or unavailable for purchase.

“It’s unethical and it’s criminal,” she said. “I had to cut down on the amount of sets I bought this year. We’re constantly in fear of whether she’ll have one when she needs it.”

Mylan and its CEO, Heather Bresch, came under fire for jacking up prices more than 400 percent in the past decade. Mylan released a statement saying it would take “immediate action to further access” to the life-saving auto-injector.

Mylan has not budged on price hikes, but announced that it would bulk up programs that help patients pay for the product. The company has received criticism from lawmakers and families that have incurred the hefty cost increase.

Because Mylan has not lowered its prices, insurers and employers that pay the majority of the EpiPen costs for many patients will continue to do so, which contributes to the high cost of insurance and health care.

For patients in health plans who face higher out-of-pocket costs, the company said it will offer a savings card for up to $300. This will effectively reduce by 50 percent the cost, according to a statement from the company.

“We recognize the significant burden on patients from continued, rising insurance premiums and being forced increasingly to pay the full list price for medicines at the pharmacy counter,” Bresch said in a statement.

“Patients deserve increased price transparency and affordable care, particularly as the system shifts significant costs to them.”

The Associated Press contributed to this report.

Copyright 2016 the Dayton Daily News

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