Anaphylaxis cost-effectiveness of therapy: Difference between revisions

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==Overview==
==Overview==


The current cost of auto-injectable epinephrine devices for the treatment of anaphylaxis are overpriced. <ref name="pmid26505932">{{cite journal| author=Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, Bernstein D, Bernstein J | display-authors=etal| title=Anaphylaxis--a practice parameter update 2015. | journal=Ann Allergy Asthma Immunol | year= 2015 | volume= 115 | issue= 5 | pages= 341-84 | pmid=26505932 | doi=10.1016/j.anai.2015.07.019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26505932  }} </ref>
The current cost of auto-injectable [[epinephrine]] devices for the treatment of [[anaphylaxis]] are overpriced. <ref name="pmid26505932">{{cite journal| author=Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, Bernstein D, Bernstein J | display-authors=etal| title=Anaphylaxis--a practice parameter update 2015. | journal=Ann Allergy Asthma Immunol | year= 2015 | volume= 115 | issue= 5 | pages= 341-84 | pmid=26505932 | doi=10.1016/j.anai.2015.07.019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26505932  }} </ref>


==Cost-effectiveness of Therapy==
==Cost-effectiveness of Therapy==


Epinephrine is the mainstay of treatment for anaphylaxis and auto-injection expenses have increased in recent years. They are currently overpriced and this began with the increasing awareness of anaphylaxis. The recommendation was to keep 2 units of epinephrine on hand for each patient and the demand for the auto injection devices has created shortages which the FDA compensated for by extending its expiration dates to 2 years. It is recommended to lower the price as well as increase the device options to allow for competition among brands. <ref name="pmid30646369">{{cite journal| author=Shaker M, Greenhawt M| title=Association of Fatality Risk With Value-Based Drug Pricing of Epinephrine Autoinjectors for Children With Peanut Allergy: A Cost-effectiveness Analysis. | journal=JAMA Netw Open | year= 2018 | volume= 1 | issue= 7 | pages= e184728 | pmid=30646369 | doi=10.1001/jamanetworkopen.2018.4728 | pmc=6324395 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30646369  }} </ref> <ref name="pmid26505932">{{cite journal| author=Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, Bernstein D, Bernstein J | display-authors=etal| title=Anaphylaxis--a practice parameter update 2015. | journal=Ann Allergy Asthma Immunol | year= 2015 | volume= 115 | issue= 5 | pages= 341-84 | pmid=26505932 | doi=10.1016/j.anai.2015.07.019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26505932  }} </ref> <ref name="pmid27673458">{{cite journal| author=Rubin R| title=EpiPen price hike comes under scrutiny. | journal=Lancet | year= 2016 | volume= 388 | issue= 10051 | pages= 1266 | pmid=27673458 | doi=10.1016/S0140-6736(16)31708-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27673458  }} </ref> <ref name="pmid26525001">{{cite journal| author=Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK | display-authors=etal| title=2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. | journal=World Allergy Organ J | year= 2015 | volume= 8 | issue= 1 | pages= 32 | pmid=26525001 | doi=10.1186/s40413-015-0080-1 | pmc=4625730 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26525001  }} </ref> <ref name="pmid28492859">{{cite journal| author=Cantrell FL, Cantrell P, Wen A, Gerona R| title=Epinephrine Concentrations in EpiPens After the Expiration Date. | journal=Ann Intern Med | year= 2017 | volume= 166 | issue= 12 | pages= 918-919 | pmid=28492859 | doi=10.7326/L16-0612 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28492859  }} </ref>
[[Epinephrine]] is the mainstay of treatment for [[anaphylaxis]] and auto-injection expenses have increased in recent years. They are currently overpriced and this began with the increasing awareness of [[anaphylaxis]]. The recommendation was to keep 2 units of [[epinephrine]] on hand for each patient and the demand for the auto injection devices has created shortages which the [[Food and Drug Administration|FDA]] compensated for by extending its expiration dates to 2 years. It is recommended to lower the price as well as increase the device options to allow for competition among brands. <ref name="pmid30646369">{{cite journal| author=Shaker M, Greenhawt M| title=Association of Fatality Risk With Value-Based Drug Pricing of Epinephrine Autoinjectors for Children With Peanut Allergy: A Cost-effectiveness Analysis. | journal=JAMA Netw Open | year= 2018 | volume= 1 | issue= 7 | pages= e184728 | pmid=30646369 | doi=10.1001/jamanetworkopen.2018.4728 | pmc=6324395 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30646369  }} </ref> <ref name="pmid26505932">{{cite journal| author=Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, Bernstein D, Bernstein J | display-authors=etal| title=Anaphylaxis--a practice parameter update 2015. | journal=Ann Allergy Asthma Immunol | year= 2015 | volume= 115 | issue= 5 | pages= 341-84 | pmid=26505932 | doi=10.1016/j.anai.2015.07.019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26505932  }} </ref> <ref name="pmid27673458">{{cite journal| author=Rubin R| title=EpiPen price hike comes under scrutiny. | journal=Lancet | year= 2016 | volume= 388 | issue= 10051 | pages= 1266 | pmid=27673458 | doi=10.1016/S0140-6736(16)31708-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27673458  }} </ref> <ref name="pmid26525001">{{cite journal| author=Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK | display-authors=etal| title=2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. | journal=World Allergy Organ J | year= 2015 | volume= 8 | issue= 1 | pages= 32 | pmid=26525001 | doi=10.1186/s40413-015-0080-1 | pmc=4625730 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26525001  }} </ref> <ref name="pmid28492859">{{cite journal| author=Cantrell FL, Cantrell P, Wen A, Gerona R| title=Epinephrine Concentrations in EpiPens After the Expiration Date. | journal=Ann Intern Med | year= 2017 | volume= 166 | issue= 12 | pages= 918-919 | pmid=28492859 | doi=10.7326/L16-0612 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28492859  }} </ref>


==References==
==References==

Latest revision as of 09:17, 15 April 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Dushka Riaz, MD

Overview

The current cost of auto-injectable epinephrine devices for the treatment of anaphylaxis are overpriced. [1]

Cost-effectiveness of Therapy

Epinephrine is the mainstay of treatment for anaphylaxis and auto-injection expenses have increased in recent years. They are currently overpriced and this began with the increasing awareness of anaphylaxis. The recommendation was to keep 2 units of epinephrine on hand for each patient and the demand for the auto injection devices has created shortages which the FDA compensated for by extending its expiration dates to 2 years. It is recommended to lower the price as well as increase the device options to allow for competition among brands. [2] [1] [3] [4] [5]

References

  1. 1.0 1.1 Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, Bernstein D, Bernstein J; et al. (2015). "Anaphylaxis--a practice parameter update 2015". Ann Allergy Asthma Immunol. 115 (5): 341–84. doi:10.1016/j.anai.2015.07.019. PMID 26505932.
  2. Shaker M, Greenhawt M (2018). "Association of Fatality Risk With Value-Based Drug Pricing of Epinephrine Autoinjectors for Children With Peanut Allergy: A Cost-effectiveness Analysis". JAMA Netw Open. 1 (7): e184728. doi:10.1001/jamanetworkopen.2018.4728. PMC 6324395. PMID 30646369.
  3. Rubin R (2016). "EpiPen price hike comes under scrutiny". Lancet. 388 (10051): 1266. doi:10.1016/S0140-6736(16)31708-1. PMID 27673458.
  4. Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK; et al. (2015). "2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines". World Allergy Organ J. 8 (1): 32. doi:10.1186/s40413-015-0080-1. PMC 4625730. PMID 26525001.
  5. Cantrell FL, Cantrell P, Wen A, Gerona R (2017). "Epinephrine Concentrations in EpiPens After the Expiration Date". Ann Intern Med. 166 (12): 918–919. doi:10.7326/L16-0612. PMID 28492859.


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