Call for allergy funding

A coroner is calling for Pharmac to fund a device that could save the lives of people with severe allergies after the death of a Hamilton schoolboy.

Peter van den Hurk, 8, died in June after suffering an acute asthma attack brought on by a sudden and severe allergic reaction to eating a cashew nut.

He was at the house of a friend whose parents were unaware he had been diagnosed with the condition, called anaphylaxis, in 2004.

Peter's parents, Diana Young and Shane van den Hurk, took him to a nearby medical centre where he was treated with adrenalin and phenergan.

His condition deteriorated rapidly and he was rushed to Waikato Hospital but could not be revived.

After an inquest last month, coroner Gordon Matenga ruled that Peter received appropriate treatment but said similar deaths could be avoided if adrenalin auto-injectors such as EpiPens were more readily available.

EpiPens administer adrenalin to those suffering anaphylactic reactions and cost between $120 and $190. Their shelf life is only six months.

They are fully funded in Australia and the UK but not here where Pharmac, the Government drug-funding agency, pays for adrenalin, syringes and needles.

Matenga said while there was no evidence an EpiPen would have prevented Peter's death, the administration of adrenalin was accepted as the "emergency treatment of choice" for anaphylaxis, Matenga said.

"It is surprising that Pharmac does not fund, even at a subsidised level, an EpiPen or similar device. There is the potential to prevent death and I ... recommend that Pharmac looks again at the possibility of funding."

Pharmac medical director Dr Peter Moodie said Matenga's recommendation would be considered as part of an "active" review.

"We are saddened to hear about the tragic death of Peter and wish to extend our sympathies to his family and friends," he said.

"Adrenalin is the recommended treatment for people with anaphylaxis and is fully funded on the Pharmaceutical Schedule ... We remain open to funding auto-injectors, subject to available funding and comparisons with other priority pharmaceuticals we are considering." Pharmac also funds syringes and needles to administer adrenalin.

An estimated 20,000 children in New Zealand are at risk of anaphylactic reactions and the cost of funding EpiPens could reach $12 million a year.

Pharmac last considered funding EpiPens in November 2005 and recommended they should be a medium priority.

Writing in the New Zealand Medical Journal at the time, Moodie said there was "good evidence" that patients prescribed injectors overseas did not carry them or carried expired devices.

Overuse for non-anaphylactic symptoms was also a possibility and he said "rigorous" training, education and management programmes would be needed if Pharmac funded the devices.

Matenga's report, released last week, said Peter's doctor told his parents they could buy an EpiPen, but they did not think cashew nuts could be fatal for their son.

He had reacted to them three times before he was formally diagnosed but not since.

Matenga hoped that by publicising his recommendation - and Peter's death - the chances of similar deaths could be reduced.

Diana and Shane were not ready to talk about his death or the coroner's findings last week.

However, in a letter to Peter's school, Hukanui School, they thanked staff and the board for supporting them and their daughter Sarah through a "huge challenge".

The family also donated $1000 to the school.

- HERALD ON SUNDAY