Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What physicians can do about EpiPen

Kristen Maguire, MD
Meds
September 2, 2016
144 Shares
Share
Tweet
Share

When I found out my daughter was allergic to peanuts, she was a year old. She couldn’t have cared less. She was smiling and happy, sitting on my lap in the allergist’s office, blissfully unaware of the big red mark on the side of her face. And I was crying and sad, crushed for that moment that the first challenge had been put in her path. I wasn’t sad that she was different, that her cheeks would never be covered in sticky PB and J or that Reese’s cups would now be off limits on Halloween. I was sad because I am not only her mom, but I am also an emergency medicine physician. I have seen children and adults arrive moments from death, their swollen tongues pushed out of ballooned lips while gasping for air.  In anaphylaxis, whether true shock or a severe allergic reaction, I have saved lives with the quick administration of epinephrine, reversing the course of an otherwise devastating disease.

Needless to say, after our appointment, I filled her prescription for EpiPen right away. I had one 2-pack at home, one in her diaper bag, and yet another at daycare. I threw out anything nut related. I notified all family and friends. I read labels, not once, but twice doing everything I could think of to keep her safe. She couldn’t even walk yet. Still, there were times I couldn’t sleep thinking what if heaven forbid one day my baby couldn’t breathe.

It’s hard to ignore the press that has surrounded EpiPen. But just in case you missed it, the drug’s cost skyrocketed to nearly $600 for a single auto-injector two pack representing a 400 percent price hike over the last 10 years. Over the past week there have been public and political requests of Mylan, the manufacturer of EpiPen, to provide some sort of justification or reduce the price.  The CEO responded by blaming the system.  Most recently the company proposed a step-wise program to bring down costs a bit.  And now Sarah Jessica Parker has stepped down as their spokesperson.

But where does that leave families like mine?  Where do we go from here? First of all, there is nothing fantastical about epinephrine itself. It’s a simple drug with a simple mechanism of action. The EpiPen has been on the market for years. There is a patent on the expensive auto-injector, but the rapid increase in cost has been entirely unjustified. Some could say it’s simple capitalism, and I would not disagree. In an easy supply and demand scenario, Mylan is being opportunistic.

Food allergies are on the rise and doctors are prescribing more EpiPens. Schools and camps are requiring individual students to provide their own pens (cue back-to-school season). A short shelf life forces you to throw out unused product annually. Mylan has nearly a monopoly going as EpiPen’s only competitor, Auvi-Q, was recalled in 2015. Even some hospitals prefer EpiPen for safety and ease of use as opposed to drawing up epinephrine into individual syringes reducing chances of medication error.

At the residency program I trained at, our unofficial motto was “do the right thing.” As an attending, I tell myself this every shift. My patients come to the ER because they either are having an emergency or they think they are. Regardless, my job is to do all that I can to help them.

I can accept sleepless nights because I’m a parent and worry about my own kids, but do I also have to worry about my patients’ inability to afford the EpiPen I prescribed? No person should die because they can’t afford a life-saving medication. No parent should have to feel the burden of not being able to afford a medication that will save his or her child’s life.

So what can we do now? Yes, progress has been made in the past few days, but we must not stop. As parents, community members and doctors we need to continue to call this crooked company out.

  • Keep calling and writing your local lawmakers and let them know you’re mad as hell.
  • Find out what hearings they are already calling into action.
  • Sign all circulating petitions.
  • Bring unapologetic awareness to those who feel immune from this problem.
  • Attend local school board meetings or meet with other parents and find out what your community’s schools are doing.
  • Dig deeper into President Obama’s School Access to Emergency Epinephrine Act signed in 2013 to see if it even is applied at your school.

You may be surprised to know that only a handful of states in our nation require schools to have an emergency stockpile of EpiPens. Students otherwise have a 2-pack on their person and extra stored at the school, most of which are tossed unused in a year. Seeing that equates to every child purchasing two 2-packs at least, that adds up big and quickly for Mylan as families are putting out this cost annually regardless of whether they used the medication or not.

Ask why camps aren’t given funding to have a stockpile of epi-pens. Most YMCA’s have life-saving AEDs. Does this make any sense? As physicians, we need to consider not prescribing EpiPens at all, instead write for epinephrine auto-injectors. Hit Mylan in the proverbial pocketbook. Educate your patients about Adrenaclick, a generic and less sexy epinephrine auto-injector that’s also a quarter of the price. Never heard of it? Neither had I until last week. Interesting, isn’t it? Inquire into and even join your hospital’s pharmacy and therapeutics committee and find out just how much they’re being gouged. Help formulate a plan to make a safer or less expensive alternative available to hospitals. The list could probably go on, and that is where we need your immediate response.

Shame on Mylan and its CEO Heather Bresch, a mom herself.  But for maybe a move this egregious, this obviously capitalistic, will wake us all up to what is really at risk. This is not about profits; it’s about people.  It’s about my people: my children and my patients.  And I won’t stop until they are more important than a CEO’s salary and shareholders’ stock.

Kristen Maguire is an emergency physician who blogs at FemInEm.

Image credit: Shutterstock.com

Prev

Direct primary care physicians are trying to rescue other doctors

September 2, 2016 Kevin 25
…
Next

MKSAP: 74-year-old woman with peripheral arterial disease

September 3, 2016 Kevin 0
…

Tagged as: Medications

Post navigation

< Previous Post
Direct primary care physicians are trying to rescue other doctors
Next Post >
MKSAP: 74-year-old woman with peripheral arterial disease

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • The risk physicians take when going on social media

    Anonymous
  • Beware of pseudoscience: The desperate need for physicians on social media

    Valerie A. Jones, MD
  • When physicians are cyberbullied: an interview with ZDoggMD

    Monique Tello, MD
  • Surprising and unlikely rewards of social media engagement by physicians

    Lisa Chan, MD
  • Physicians who don’t play the social media game may be left behind

    Xrayvsn, MD

More in Meds

  • The real cause of America’s opioid crisis: Doctors are not to blame

    Richard A. Lawhern, PhD
  • Can personalized medicine live up to its hype in health care?

    Ketan Desai, MD, PhD
  • The effects of the nationwide stimulant shortage on a private psychiatry practice

    Christine Tran-Boynes, DO
  • Why North American medical cannabis can’t compete globally

    Michael Sassano
  • How were we duped and what can we do about the opioid overdose crisis?

    Ronald A. Zent, MD
  • Caught in the middle: How health insurance companies influence cancer drug selection

    Paul Pender, MD
  • Most Popular

  • Past Week

    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Breaking the cycle of misery in medicine: a practical guide

      Paul R. Ehrmann, DO | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • Unlock the power of physician compensation data in contract negotiations [PODCAST]

      The Podcast by KevinMD | Podcast
    • From pennies to attending salaries: Why physicians should teach their kids financial literacy

      Michele Cho-Dorado, MD | Finance
    • From solidarity to co-liberation: Understanding the journey towards ending oppression

      Maiysha Clairborne, MD | Physician
    • Changing the pediatric care landscape: Integrating behavioral and mental health care

      Hilary M. Bowers, MD | Conditions
    • Contract Diagnostics is the only firm 100 percent dedicated to physician contract reviews

      Contract Diagnostics | Sponsored
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 55 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Pregnant, Black? Here's Your Drug Test
  • Progestin-Only Birth Control Linked to Small Increase in Breast Cancer Risk
  • Fatty Acid Tube Feeding May Backfire for Preemie Breathing Disorder
  • Case Reports Detail Vision Loss Linked to Recalled Artificial Tears
  • Admin Trumps Med Students: Anti-Abortion Group Allowed on Campus

Meeting Coverage

  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Second-Line Sacituzumab Govitecan Promising in Platinum-Ineligible UC
  • Trial of Novel TYK2 Inhibitor Hits Its Endpoint in Plaque Psoriasis
  • Durable Vitiligo Responses With Topical Ruxolitinib
  • Most Popular

  • Past Week

    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Breaking the cycle of misery in medicine: a practical guide

      Paul R. Ehrmann, DO | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • Unlock the power of physician compensation data in contract negotiations [PODCAST]

      The Podcast by KevinMD | Podcast
    • From pennies to attending salaries: Why physicians should teach their kids financial literacy

      Michele Cho-Dorado, MD | Finance
    • From solidarity to co-liberation: Understanding the journey towards ending oppression

      Maiysha Clairborne, MD | Physician
    • Changing the pediatric care landscape: Integrating behavioral and mental health care

      Hilary M. Bowers, MD | Conditions
    • Contract Diagnostics is the only firm 100 percent dedicated to physician contract reviews

      Contract Diagnostics | Sponsored
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What physicians can do about EpiPen
55 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...