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Keep EpiPens available and affordable

Like Narcan, like a defibrillator, like the Heimlich maneuver, an EpiPen is a medical treatment to be used first and discussed later.

In the meanwhile, it may have saved a life. The medicine it dispenses through a jab in the thigh alleviates the symptoms of severe allergic reaction, including inability to breathe and anaphylactic shock. It is often, like the antidotes for drug overdose, cardiac arrest or choking, applied by a person with no medical training — quite often by the victim himself or herself.

EpiPens and similar apparatus deliver the Pfizer drug epinephrine or a related medicine immediately. Having a set on hand — they are sold in two-packs, to ensure a back-up — makes it safe for a child or adult with a severe allergy to go about the daily business of life knowing that if a peanut or a bee or other allergy suddenly strikes, they can neutralize the threat.

The devices have become standard school supplies in many families. The market is vast, which makes it all the more problematic that EpiPens have become scarce as well as exorbitantly expensive.

The Wall Street Journal reported last week that a months-long global shortage of EpiPens, blamed in part on needed manufacturing revisions at a Pfizer plant in Missouri, continues as the peak season for filling epinephrine prescriptions unfolds. The Journal says that about 40 percent of sales occur during the back-to-school period.

A shortage of devices poses a serious worry just as parents are sending children and teenagers off to school and young adults away to college. Away from home, even if just for the school day, a young person may have to handle an allergic reaction on his or her own.

The shortage and the persistent high costs of the devices, which are sold by Mylan, caught the attention of U.S. Sen. Richard Blumenthal, D-Conn., this week. Blumenthal used an event in West Hartford attended by school officials and parents of kids with allergies to announce he will propose a bill called the Cure High Drug Prices Act, aimed at reducing price gouging by pharmaceutical companies.

Mylan agreed a year ago to pay the federal government $465 million for overcharging Medicaid for EpiPens in the previous 10 years. Some in Congress objected that the overcharges were really over $1 billion and the penalty too low. During the same period, the consumer price of each two-pen kit zoomed 548 percent to $600 and more, where it remains. Insurance copays put a substantial share of that on the patient.

Some generic EpiPens are already on the market, and more are coming on, but not fast enough, according to the Journal.

We have come a long way since the 1970s when an allergic person carried a hypodermic syringe and EMTs — hospital paramedics were still in the future — were not allowed to administer the injection. The victim had to do that herself, provided she had time before passing out.

It's common to hear older Americans say they don't remember so many allergies, asthma cases and allergy-related ailments from their own childhood. The number and variety of allergies are seemingly on the rise but another factor may well be that EpiPens have allowed severely allergic people to lead normal lives, not having to sequester themselves from possible exposure. EpiPens made self-administration much less of a big deal, reducing not only the severity of the allergic reaction but the anxiety and panic when one occurred. More survive and more thrive.

The crux of this matter is the same one that arises whenever the subject is what pharmaceutical companies charge for life-saving and life-changing medicine. Research and production are costly, but a drug that in use as long and as widely as epinephrine has paid back the cost to develop it many times over. Life is priceless; with a worldwide market, there is no reason for the drugs to be.

The Day editorial board meets regularly with political, business and community leaders and convenes weekly to formulate editorial viewpoints. It is composed of President and Publisher Tim Dwyer, Editorial Page Editor Paul Choiniere, Managing Editor Tim Cotter, Staff Writer Julia Bergman and retired deputy managing editor Lisa McGinley. However, only the publisher and editorial page editor are responsible for developing the editorial opinions. The board operates independently from the Day newsroom.


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