title: The High Cost of Epinephrine Autoinjectors and Possible Alternatives.
abstract: Epinephrine autoinjectors provide potentially life-saving therapy for pediatric and adult subjects with systemic allergic reactions, including anaphylaxis. However, the cost of these devices, specifically the EpiPen (Mylan, Canonsburg, Pa), is increasing exponentially. Epinephrine autoinjectors are commonly prescribed in the United States but are not readily available worldwide. Alternatives for the self-administration of epinephrine exist and should be considered for patients who cannot afford or do not have access to these devices. The epinephrine prefilled syringe, stored in an eyeglass or pencil case, is a safe and viable option for the self-administration of epinephrine. Epinephrine prefilled syringes may not be as ideal as using autoinjectors but are superior to patients living without access to this medication.
authors.affiliation: Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine and James A. Haley Veterans' Affairs Hospital, Tampa, Fla. Electronic address: apepper1@health.usf.edu.
authors.forename: Amber N
authors.initials: AN
authors.lastname: Pepper
authors.affiliation: Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine and James A. Haley Veterans' Affairs Hospital, Tampa, Fla.
authors.forename: Emma
authors.initials: E
authors.lastname: Westermann-Clark
authors.affiliation: Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine and James A. Haley Veterans' Affairs Hospital, Tampa, Fla.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Lockey
mesh_terms: D000707:Anaphylaxis / Q000209:etiology / Q000517:prevention & control*; D004837:Epinephrine / Q000627:therapeutic use*; D005252:Fees, Pharmaceutical; D005102:Health Expenditures; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000453:epidemiology*; D012646:Self Administration; D013594:Syringes; D014481:United States / Q000453:epidemiology
chemical_list: D004837:Epinephrine
keywords: Ampule; Anaphylaxis; Cost; Epinephrine; Epinephrine autoinjectors; Prefilled syringe; Price; Systemic allergic reaction