The skyrocketing price for the rescue medication carried by people at risk for potentially life-threatening anaphylaxis has created a furor in the U.S., but there’s no need for Canadians who use the device to panic, says the head of Food Allergy Canada.
“The regulatory pricing system here is different than in the U.S., and so we have not seen huge increases for the device year over year,” Laurie Harada, the organization’s executive director, said of the EpiPen.
In the U.S., the EpiPen is sold by pharmaceutical company Mylan, which incrementally hiked its price more than 500 per cent over the last nine years, pushing its list price for a two-syringe pack from US$94 to more than US$600.
Canadians pay around C$120 for a single auto-injector, with the price varying somewhat, depending on an individual pharmacy’s dispensing fee, Harada said Thursday.
EpiPen in Canada is distributed by Pfizer, which licenses the injectable epinephrine from Mylan. A rival anaphylaxis rescue medication, sold as Allerject in Canada, was pulled from the market last year because of the potential for inaccurate dosing.
Anaphylaxis is a severe reaction, which can occur in response to toxins from insect bites or from eating foods like peanuts, fish, eggs or milk in people with allergies to those substances.
“The most severe response is when somebody’s airways are swelling and they’re closing,” said Harada. “They’re going to lose the ability to breathe or their blood pressure is dropping.”
An immediate shot of epinephrine, typically injected into the muscles of the thigh, can alleviate those effects and buy time until paramedics arrive.
The uproar in the U.S. about what’s been called Mylan’s “price-gouging” comes at a time when the market for EpiPens is experiencing a seasonal spike, as parents stock up before their children with severe allergies head back to school.
“We see peak seasons, often back-to-school, because the awareness is up there and also a lot of the schools in Canada have policies in place where if a family has identified their child as being at risk for anaphylaxis … a lot of the schools are asking that the kids carry an auto-injector with them,” said Harada.
“And many of the schools also ask for a backup dose, in case one is needed.”
An estimated 7.5 per cent of Canadian adults and children have food allergies that put them at risk for anaphylaxis, she said. Overall, about two per cent of the population are in danger of the life-threatening condition due to reactions to all kinds of allergens, including toxins from bug bites and medications such as penicillin.
About one per cent of all annual emergency department visits are attributed to allergic reactions, including anaphylaxis, according to data published last year by the Canadian Institute for Health Information (CIHI). In 2013–2014, that represented about 170,000 allergy-related visits across the country, CIHI calculated.
National death rates from anaphylaxis are difficult to determine, said Harada. But data from a 2013 McMaster University study showed 80 people in Ontario died from the severe allergic reaction between 1986 and 2011. Of those who died, only a quarter had received a shot of epinephrine, in some cases because they weren’t carrying an injector or the medication had expired.
Harada said the epinephrine auto-injectors are usually potent for 12 months, but consumers should make sure they check the expiry date before purchasing the devices.