EpiPen shortage fraying parent’s nerves of kids with allergies

Published 8:34 am Friday, September 28, 2018

By Martin Moylan

MPR News/90.1 FM

Deb Carlson of St. Paul needs three pairs of EpiPens for a child who has a life-threatening allergy to peanuts and tree nuts. One set of EpiPens is at school, one at daycare and another at home. And Carlson worries about finding replacements if any of the devices have to be used.

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“All the major manufacturers have a shortage at the moment and it’s very difficult to find them,” Carlson said. “If I were in a position where I needed them it would be very difficult to find anything at this point.”

EpiPens or other devices deliver the medication epinephrine, which protect people when they have severe reactions to insect stings, foods, and other allergens.

But there’s been a widespread shortage of EpiPens and comparable generic devices that deliver medication to tame allergic reactions.

Carlson said there’s much discussion on social media and on support group sites about hunting for EpiPens.

“All over the country people are having a hard time finding them,” Carlson said.

The Food and Drug Administration says the EpiPen is the most-widely prescribed system for delivering epinephrine in the U.S. It is used to treat an acute allergic reaction, called anaphylaxis. The episodes represent a medical emergency that affects the whole body and, in some cases, leads to death.

Nearly one in 50 people in the U.S. are vulnerable to anaphylaxis episodes, and nearly 6 million children in the U.S. have food allergies.

In a statement, the FDA said it understands families and communities may be experiencing shortages of EpiPens. But the FDA says the EpiPen and similar products are available, though people may have to hunt for them.

The FDA notes the website of the manufacturer, Mylan, offers people guidance about where to find EpiPens. And the FDA is reminding people that there are alternative epinephrine auto-injector products that can be used safely and effectively.

The agency has also said patients may use an expired dose in some circumstances. But they but should call 911 and receive follow-up medical treatment.

If an injection device has a viewing window and the solution appears cloudy or discolored, the agency advises against using it.

“There has been a national shortage that’s affected two out of the three EpiPen auto-injectors on the market in the U.S.,” said Lisa Gable, CEO of Food Allergy Research and Education, a nonprofit. “And that’s obviously caused a crisis for families across America as they have taken children and headed back to school.”

Gable said 82 percent of people responding to a survey on the organization’s website indicated they were having trouble finding EpiPens.

“It’s a scramble. We’ve had people who are driving 90 miles away in order to get what they need,” Gable said. “In the state of California, Kaiser has actually only been filling half of their prescriptions.”

Gable said drug manufacturers have indicated supplies should improve in the final three months of this year. Meanwhile, she said her organization is not aware of any deaths resulting from people failing to get medication.

A spokeswoman for CVS Pharmacy said the big chain is not experiencing a widespread shortage of epinephrine auto-injectors. But there may be instances when individual stores may be temporarily out-of-stock.

The company said patients should call their local pharmacy ahead of time to ensure they have the medication, or can get it from another pharmacy.

Epipen supplies vary from store to store, said Jason Varin, president of the Minnesota Pharmacists Association.

“I talked with two of the chain pharmacies and two independent pharmacies. And it’s a sporadic supply at best,” he said. “One of them had not received a shipment of EpiPens for six weeks.”

Varin said much depends on the distributors supplying pharmacies. Some distributors get more shipments than others. Some distributors are a priority for manufacturers. Some are not.

In the metro area, Varin said odds are that if one chain pharmacy doesn’t have EpiPens, the staff can readily find them at another store in the chain.

In an emergency, he said hospitals and ambulances should have EpiPens or similar devices available.

But for folks living in rural areas, things are much more dicey. It’ll take longer for an ambulance to arrive or get to a hospital. So, Varin says in rural areas people have to be even more vigilant about making sure they are not out of epinephrine.

“If it’s an emergency obviously you call 911 in any event, regardless if you have the EpiPen or not,” he said.