The following is a guest post from Mireille Schwartz, author of the forthcoming When Your Child Has Food Allergies: A Parent’s Guide to Managing it All–From the Everyday to the Extreme (AMACOM April 2017), on this year’s back-to-school pharmacy visit and its collision with the recent EpiPen price controversy.
Two weeks ago, as part of my family’s back-to-school ritual, my daughter and I made an annual trip to our local pharmacy in order to refill her epinephrine auto-injector two-pack prescription. When your child has food allergies, there are certain times each calendar year that are pivotal touchpoints for safety: the birthday party, Halloween, winter holidays, and back-to-school. Families with food allergies survive and thrive with plenty of planning, and with strategies firmly in place to handle and manage the inevitable allergen exposures along the way. The epinephrine auto-injector is a huge part of this strategy.
Once a severe allergic reaction starts, epinephrine is usually the first line of defense to treat the situation. It’s a synthetic adrenaline that can reverse the severe symptoms of an allergic reaction in – literally – seconds. The medication is loaded up into an auto-injectable device, commonly referred to as the ‘EpiPen’ after the best-known brand, and one shot can stop an allergic reaction in its tracks. It’s considered the first and best solution in combating food allergies once they have been triggered. The epinephrine raises dangerously low blood pressure by tightening the blood vessels. The lung muscles relax, breathing eases, and swelling reduces in the throat and face. Then the heart rate increases as blood pressure rises, delivering the epinephrine faster to the whole body.
Unlike antihistamine tablets and syrups like Benadryl – also useful, but not as fast-acting – epinephrine is available by a prescription only, and the shelf-life of the medication is slightly more than 12 months, meaning that refills are needed annually. The back-to-school season is a natural time to re-up: school is the ultimate zone for those inevitable allergen exposures.
The end-of-summer trip to the pharmacy is typically pretty boring, with some waiting around, then the polite small talk with our pharmacist followed by the handoff. This time, however, while we waited, we could see a buzz building behind the counter. Our pharmacist scowled at his computer screen, clicking a button over and over on his keyboard. Our eyes met, he quickly looked away, and he summoned over the head pharmacist. Together they began a quiet and heated discussion with the monitor’s glow on their frowning faces. Next, a third pharmacist walked up and tried her hand at the computer keyboard, while the three conferred in hushed tones.
My daughter and I are dependent on these EpiPens. As inconceivable as it was for me to consider, I had to ask: “Is there a problem with our prescription?” The head pharmacist was apologetic as he told me and my daughter, “I’m sorry, but even with your EpiPen coupon, the charge for your daughter’s medication today is $700.” He was clearly uncomfortable and caught off guard. I asked all of the questions a parent asks: was this for ALL the refills available for the entire year? Was this an error of some kind? The pharmacist couldn’t explain it, and he was as astounded as I was.
For Mylan, the pharmaceutical company that manufactures the EpiPen, back-to-school is the ultimate time to gouge the customer—a customer desperate and dependent on the product. This price hike also happened directly following the removal of the other leading epinephrine auto-injector, Sanofi’s Auvi-Q that “talked you through” its use, from the market. A generic alternative has not yet arrived for consumers. And so it looks like Mylan, the EpiPen manufacturer, has done the cold and calculated unthinkable to us.
This week I’ve heard countless stories from families dejected to hear the same bad news at their own pharmacies all across the country. In some towns the EpiPen price surpassed $1,000. Families were frightened, many left without their child’s medications. No lifesaving medication for the school year.
Earlier this week, I met with my daughter’s school and handed them her brand new EpiPen two-pack. I also swapped out the soon-to-expire EpiPen two-pack in her personal emergency bag, carried daily in her backpack.
How many other families this week did not?
Food allergy expert & author MIREILLE SCHWARTZ imparts wisdom gathered during her lifetime with food allergies in her upcoming book, When Your Child Has Food Allergies (AMACOM April 2017). She’ll share the stories behind the stories, and with them the health, safety, efficacy, common sense, and fragilities that make us who we are. “Food is everywhere, and our relationship to food needs to be healthy if we are to stay healthy,” Schwartz says. The author lives with her family in San Francisco.