New Zealand allergy community 'buzzing' over cheaper lifesaving adrenaline auto-injectors

Senior political reporter, NZ Herald·NZ Herald·

26 Sep, 2018 05:00 PM5 mins to read

Allergy NZ CEO Mark Dixon says manufacturing costs of generic versions of adrenaline auto-injectors could be substantially more affordable. Photo / Getty Images

The New Zealand allergy community is "buzzing" at the prospects of cheaper life-saving adrenaline auto-injectors after the approval of a generic version in the United States.

The devices contain adrenalin, which is injected through a spring-loaded needle into the muscle of the leg, and are used to treat potentially life‑threatening allergic reactions.

There had been outrage at rising costs of the EpiPen brand in the United States, after Mylan Pharmaceuticals bought the rights to the anaphylaxis treatment in 2007, boosting the price from US$93 ($139.29) for two injectors to more than US$600.

In August, the US Food and Drug Administration approved the first generic version of EpiPen and EpiPen Jr auto-injector, produced by Teva Pharmaceuticals USA.

The FDA said it would give patients a lower-cost option and help protect against potential drug shortages.

While there had been no application yet to Medsafe in New Zealand to register it here, Allergy New Zealand chief executive Mark Dixon said the potential was "exciting".

Mylan EpiPens were not subsidised by Pharmac, and could cost between $120-$250 each, Dixon said. They could be used only once, and expired after a year.

About 10,000-15,000 EpiPens are sold in New Zealand each year, Dixon said.

"As you can imagine a lot of families currently simply can't afford them. Allergy families carry the full burden as there is no government support."

Pharmac currently funded adrenaline in an ampoule that could be used with a needle and syringe by people experiencing anaphylaxis. The ampoules cost about $1 each.

However, this was often challenging for some sufferers and their supporters to administer.

"They also have to know how to assemble and inject it, which can be difficult, especially in an emergency."

Dixon said adrenaline auto-injectors had been on Pharmac's waiting list for more than 13 years, with budget concerns being the major factor.

If the pens were subsidised the number of people using them could increase dramatically.

Dixon said manufacturing generic adrenaline auto-injectors could make them substantially more affordable for those in need.

"A new generic supplier in the world market changes everything. The community is buzzing.

"Our members win if the price goes down or there is a partial subsidy. It does not matter what brand is on the packaging, supply and price is the problem."

Pharmac director of operations Lisa Williams said although it was in close contact with potential suppliers, it had not received an application for funding from the new generic supplier.

"We continue to be in close contact with all potential suppliers of adrenaline auto-injectors with the aim of negotiating an affordable long-term funding agreement.

"Currently, EpiPen is the only brand of adrenaline auto-injector registered by Medsafe.

"Pharmac has communicated our interest in the product to other potential suppliers, with a view to them submitting an application to Medsafe for registration in New Zealand and a funding application to Pharmac."

Case Study: "It's a daily anxiety."

Eliza Pryor's allergy to peanuts makes birthday parties an ordeal. Photo / Dean Purcell

Eliza Pryor just wants to be a normal 10-year-old, but her anaphylactic allergy to peanuts makes everything more difficult.

"She is 10 years old and has never had a sleepover at a friend's house," said her mother, Carlene.

"Even birthday parties are an ordeal. Each time we have to explain to the parents her allergies and what to do and how to be careful."

Eliza's one major reaction was when she was 1 year old, after she shared a drink bottle with somebody who had just eaten a peanut-butter sandwich.

At the time her family were not aware of the extent of the allergy, and had not been advised to carry an EpiPen.

Pryor gave her daughter antihistamines, which kept the swelling at bay enough to get her to hospital.

"Through vigilance she has not had contact with peanuts since, but it's a daily anxiety."

Ever since then the family had been carrying EpiPens as part of an emergency kit for Eliza, but the annual cost was a constant stress on the family.

"The last time I bought one, an EpiPen Jr, from our GP about five years ago it cost $160.

"We could only buy one, so I had to drop it to the school office and pick it up again every day.

"Then I started importing them from the United Kingdom, where I could get two for about $145, however that's still expensive for us and I find the process stressful each year.

"This year we haven't even managed to fit it into the budget so we only have expired pens at the moment.

"It's completely crazy to me that lifesaving medication, which is absolutely essential to so many people, is still not subsidised."

Pharmac does not fund EpiPens, but it does fund adrenaline in an ampoule that can be used with a needle and syringe by people experiencing anaphylaxis. The ampoules cost about $1 each.

Pryor said although it is more affordable it is not practical.

"There's no way my daughter can lead any kind of normal life that way. Can you imagine dropping your kid off to a birthday party with her emergency vials and needles and explaining to the parent what to do in an emergency?"

Lowering the cost of EpiPens, or alternative generic adrenaline auto-injector, would be "incredible", Pryor said.

"It would give us so much more peace of mind."