EpiPens Not Getting To Children That Need Them: Study

More than two-thirds of children with severe allergic reactions are not treated with an EpiPen before being taken to the ER or urgent care, according to the findings of a new study that raise further concerns about the availability of the emergency drug. 

Epinephrine, sold under the brand name EpiPen, is the recommended first response for anaphylaxis. The medication inhibits severe and life-threatening allergic reactions, and is given via a simple self-administered injection pen. Epinephrine helps to narrow blood vessels and open the lung airways during severe allergic reaction.

According to findings of a study published in the Annals of Allergy, Asthma & Immunology, many children simply are not getting treated with an EpiPen to help stop the onset of anaphylaxis, before being taken to the emergency room (ER).

Researchers conducted a retrospective review of medical records for more than 400 patients 0 to 25 years, who were treated for anaphylaxis at an ER or urgent care center between 2009 to 2013. The average age of patients was 7 years old.

Of the 400 patients, only 36 percent received EpiPen injections before arriving at the ER or urgent care center. That amounts to 148 patients. The data also indicated patients who experienced reactions at home were less likely to be treated with an EpiPen, compared to those who had reactions at school.

Researchers said EpiPen administration is occurring with “considerable delay,” especially when children need it most to save their lives.

Overall, children who experienced a reaction involving 2 or 3 organs, like skin, eyes, stomach or respiratory tract, were less likely to be given EpiPen injections, than those whose reactions only involved 1 organ.

Children who didn’t get the EpiPen before being taken to the ER were significantly less likely to be discharged to go home.

One barrier to children not receiving EpiPen treatment when needed may be the high price of the drugs. Mylan Specialty has come under fire in recent months for price inflation of EpiPens. The company charges $600 for a two pack of EpiPens, which cost $100 a decade ago. Generics are now sold for about $300.

Anaphylaxis occurrence has increased during the past two decades. Researchers indicate foods are the most common trigger of anaphylaxis. Other triggers included medications, venom and latex. Quick injection with an EpiPen is recommended as the first line of treatment when anaphylaxis begins to prevent the risk of death.

Severe allergic reactions typically begin within 5 to 30 minutes after exposure to a trigger. In some cases, it can take up to an hour. Symptoms include rash, hives, swelling of the face, lips and ears, wheezing, chest tightness, trouble breathing, vomiting, diarrhea, stomach cramps, and passing out.

Researchers warn awareness of proper anaphylaxis treatment and education for parents and caregivers is key to help them prevent severe side effects before heading to the ER.