High cost of auto-injectors ‘big problem’

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There are fears some severe allergy sufferers are going without a supply of adrenaline in a bid to inject money into other daily necessities.

Allergy New Zealand CEO Mark Dixon talks to The News reporter Alexia Johnston about the New Zealand-wide issue as part of World Allergy Week this week.

Pushing for change . Allergy New Zealand CEO Mark Dixon wants adrenaline filled auto-injectors to be subsidised. PHOTO: SUPPLIED/ ALLERGY NEW ZEALAND

A syringe filled with adrenaline is a lifeline to many New Zealanders.

That syringe – an auto-injector – can save a person’s life when suffering anaphylaxis.

But, at a cost of between $120 to $250 and a shelf life of just 12 months at the most, the life-saving device is out of reach for many people.

Allergy New Zealand CEO Mark Dixon said there was a real concern that some parents and individuals were struggling to keep up with other costs, such as putting food on the table, so were going without a supply of adrenaline as a result.

“It is a very big problem.

“We also believe there are a lot of people carrying expired [auto-injectors] as well, because they can’t afford to replace these; and may not be seeing their doctor regularly to get their anaphylaxis action plans updated, because they can’t afford the [auto-injector].”

A common brand of auto-injector in New Zealand is the EpiPen.

He said some people who required the device might be able to get financial assistance, or if it was for a child, from their school.

“Where possible, we would also like people to contact their local MP and ask them to help.”

Mr Dixon said an auto-injector, which was spring-loaded to get the adrenaline to where it needed to go, was a lifeline.

“It is a very big problem.” – Allergy New Zealand CEO Mark Dixon

“It is like having a seat belt – people at risk of anaphylaxis need to have it with them at all times, just in case. If they do have a severe reaction, the adrenaline (injected by the EpiPen) works rapidly to reverse the effects of anaphylaxis and is the first line treatment for anaphylaxis.”

The auto-injectors contain a single, fixed dose of adrenaline, and have been designed to be given by non-medical people such as a friend, teacher, childcare worker, parent, passer-by, or by the patient themselves, if they are able to.

Mr Dixon said Allergy NZ had been campaigning “for years” to get the auto-injectors subsidised. Those campaigns have included petitions and applications to Pharmac, which provides funded access to pharmaceuticals.

Mr Dixon said Pharmac’s process was not transparent.

It appeared the funding model does not work for EpiPens so we would need that to change if we are ever to get a subsidy, he said.

“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.” – Pharmac director of operations Lisa Williams

“EpiPens and other adrenaline auto-injectors are subsidised in many other countries, including two per eligible patient per year in Australia, where they use a different decision-making approach than Pharmac does here.”

Pharmac director of operations Lisa Williams said the EpiPen brand of adrenaline auto-injector was the only one registered in New Zealand by Medsafe, which was why the supplier was able to set a high price.

“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.”

However, unlike other countries, Pharmac works within a fixed budget for medicines, which meant “we must make careful and considered choices” about which medicines would deliver the best health outcomes for New Zealanders, she said.

“We take this responsibility very seriously.”

She said the difficulty with EpiPens was that the cost was very high compared to adrenaline that comes in other forms.

“Pharmac already funds adrenaline in an ampoule (glass vial). This form of adrenaline can be used with a needle and syringe by people experiencing anaphylaxis. The ampoules cost about $1 each. Auto-injectors, like the Epipen, can be more than 100 times more expensive while containing the same active ingredient.”

Although it was a cheaper option, Mr Dixon said it was not practical or the safest or easiest method for people, particular if they were suffering anaphylaxis and had to administer the adrenaline themselves.

“We take this responsibility very seriously.” – Pharmac director of operations Lisa Williams

He also challenged Pharmac to specify what training they provided with their funded solution.

Ms Williams said Pharmac had communicated its 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.