Aug 16 2018

EpiPen Shortage Persists as Students Head Back to School

Parents with EpiPens on their back-to-school shopping lists have been alarmed to find the items in short supply, as the nationwide shortage that began earlier this year has apparently not abated.  The EpiPen and EpiPen Jr. devices deliver the lifesaving drug epinephrine during severe allergic reactions, and are often carried by students, and stocked in school health offices.

As of mid-August, the Food and Drug Administration (FDA) still had the Mylan-manufactured devices – both branded and generic versions -- included on its “list of drug shortages.”  Both the 0.3 mg and 0.15 mg auto-injectors are listed as “available,” but the accompanying information notes “intermittent supply constraints from the manufacturing partner, Meridian Medical Technologies, a Pfizer company.”  Patients unable to locate an EpiPen are encouraged to call Mylan Customer Relations at 800-796-9526 “for assistance in locating alternative pharmacies.”

In a statement posted on its website, Mylan notes that “Pfizer is working hard to increase production and stabilize supplies, but until this occurs, supplies of EpiPen 0.3mg and EpiPen Jr. 0.15mg Auto-injectors, and the authorized generic versions of these strengths will continue to vary from pharmacy to pharmacy, and may not always be available.”

The Mylan statement noted that its customer service team has been successful in locating product, and encouraged patients to call their 800-number if they experience difficulty.

Another option is to consider alternatives.  But, as the American Pharmacists Association’s Pharmacy Today points out, many parents accustomed to the EpiPen have expressed hesitancy about switching to a different product.  Nevertheless, alternatives do exist, although supply issues threaten availability in some instances.

Impax’s Adrenaclick is also experiencing “spot shortages,” and is listed on the FDA’s drug shortages compilation.  Impax also offers a generic version of the branded Adrenaclick device, which comes in a package of two and is available through CVS.  However, in June 2018 Impax issued a warning that certain lots of its generic auto-injector, while having “passed all levels of inspection and met product specifications at the manufacturing facility…have been found to contain particles upon further inspection.”  Patients are advised to visually inspect the epinephrine solution, and if it is determined to contain particles, to not use the product and return it to a pharmacy.

Another option is AUVI-Q, manufactured by Kaleo, and available through a direct delivery service.  According to Pharmacy Today, AUVI-Q is available for no out-of-pocket costs to patients with commercial or government insurance whose household income is less than $100,000.  AUVI-Q is currently listed by the FDA as “readily available and not currently in shortage.”

As concerned parents and health professionals take steps to procure adequate supplies of epinephrine, pharmacists will be an integral source of information and assistance.  Pharmacists will be especially helpful in providing instruction in how to use specific devices since not all injectors operate in the same manner.