MONDAY 14 Nov. 2022 (HealthDay News) — The EpiPen is a known lifesaver when someone with a severe food allergy eats something they can’t tolerate.
Yet, according to a new study in the United States, the auto-injection treatment is vastly underused.
Just over half of at-risk adults said they had been given the device at some point, researchers found. And more than a third of people with severe allergies mistakenly believe that the EpiPen itself poses a serious threat to their health.
“The results were eye-opening,” said study co-author Erin Malawer, executive director of AllergyStrong based in McLean, Virginia.
Food allergy affects more than 32 million Americans. EpiPens contain epinephrine, the only drug that can stop life-threatening anaphylaxis, which can occur as a result of a severe allergic reaction.
About 1,000 patients were surveyed online. Those who didn’t have an EpiPens on hand gave a wide variety of reasons, including insurance issues. Without health coverage, Malawer said the injectors cost hundreds of dollars for a two-pen kit, which is standard protocol. Brand-name EpiPens, marketed by Mylan Pharmaceuticals, sell for about $700, while generic versions cost about $350, according to healthshare101.com.
Survey respondents also mentioned a lack of access to doctors and/or pharmacies; out of stock pharmacies; and fear of needles.
“The biggest surprise was that a whopping 25.6% of our respondents responded that the reason they didn’t have (EpiPen) was because their doctor didn’t indicate it was necessary,” Malawer added. “This has to change.”
Only 52% had been prescribed an allergy pen, and 36% endorsed the belief that EpiPens can cause life-threatening side effects, the researchers found.
The researchers “did not examine the genesis of this mistaken belief,” said study co-author Jennaveve Yost, an education and health research manager at Food Allergy Research & Education in Burke, Virginia. But she pointed out that the anti-vaccine movement “is probably not helping the narrative that epinephrine is a safe and effective medication.
Another possibility, she said, “is the misunderstood belief that Benadryl — a first-generation antihistamine — is the right first-line course of action against an allergic reaction. Compared to Benadryl — which is affordable and available on pharmacy and drugstore shelves. medicine has been in closets for decades – injectable epinephrine seems to be an extreme treatment.
Yost also said the high cost of epinephrine and the inconvenience of having to lug it around give people “just enough excuse to wonder if it’s necessary in the first place.”
The findings were presented last week at the annual meeting of theAmerican College of Allergy, Asthma & Immunology, in Louisville, Ky. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.
What can be done?
Epinephrine needs to become more accessible and affordable, Malawer said.
It is the job of doctors and nurses “to make time to discuss how and when to use epinephrine auto-injectors, and to discuss which style and brand is best for that particular patient’s lifestyle,” she added. effectiveness when used at the first sign of a severe allergic reaction, she added.
Dr. John Costa is medical director of the division of allergy and clinical immunology at Brigham and Women’s Hospital in Boston. He said the study results are surprising, given that allergists in general already spend “an enormous amount of time on patient education” regarding EpiPen use.
Costa, who was not involved in the study, said allergists are pushing for EpiPen use because of the potentially fatal consequence of not having it on hand.
“If you ate a food you’re allergic to and your throat closes up and you’re gasping for air, the chances of you dying in the next 5 minutes would outweigh any concerns about [EpiPen] adverse side effects,” Costa explained.
His bottom line: All patients should have an EpiPen on hand at all times.
Costa tells patients that the EpiPen is their “nuclear weapon to treat a systemic food allergy and save their lives. It is their best friend and should be used when in doubt because there is minimal chance of a serious side effect.”
There is more about epinephrine autoinjectors at the American College of Allergy, Asthma & Immunology.
SOURCES: Jennaveve Yost, MS, education and health research manager, Food Allergy Research & Education, Burke, Va.; Erin Malawer, Executive Director, AllergyStrong, McLean, Va.; John J. Costa, MD, medical director, division of allergy and clinical immunology, Brigham and Women’s Hospital, Boston, Massachusetts; presentation, American College of Allergy, Asthma & Immunology, November 10-14, 2022, Louisville, Ky.