I’d love to see a follow up article on this. The epipen was out of stock at our pharmacy in December.
Almost March and still no Epipens available.
Shortage is still ongoing. Our Pharmacy cannot even submit an order for the medication and the manufacturer has no pending release date!!!
Hmmm, public outcry over massive increases in price for a product; then the product mysteriously disappears from pharmacy shelves? Retribution?
4
It frustrates me to no end to see shortages like this one, endangering millions of lives including the lives of my loved ones, for no good reason. Epinephrine isn't in short supply. Neither is salt, nor is water - my tiny research lab is equipped with enough of these commodities to make hundreds of Epi-pens and gallons of sterile saline. The only reason why people are needlessly suffering and dying is the unrestricted consolidation of manufacturing facilities in the interests of the petty god Shareholder Value - expect these shortages to increase as failing infrastructure and climate change-driven extreme weather contribute to shut down more plants, each plant being the only source of an essential medication.
9
Let’s see if we have this correct...EpiPens are in short supply because of a manufacturing problem by the same companies that not too long ago tried to escalate the prices on the life-saving devices and failed to do so because of a public uproar.
So, Big Pharma can’t get its manufacturing in sync with the patient’s needs, really? Yet illegal drug manufacturers seem to be able to keep the supply flowing year after year after year without interruption its consumers demand for cocaine, meth, and knock-off opioids.
If I was a cynic, I’d say Big Pharma falsely created the shortage as their latest attempt to jack up the prices for the EpiPen!
10
I just received the Auvi-Q twin pack less than a week after it was prescribed. (It is mailed) These are smaller units and a recording "talks" you through injecting. Aetna wouldn't allow it, but Cigna does - it's less expensive and easier to use.
1
I wonder if the expiration date is a true reflection of when the product is no longer useful or is a marketing ploy to sell more product. Also, only selling the item in a 2 pack is a recent development which I am sure contributes to the shortage. Normally when you buy a prescription drug - you use the product, so you feel you have gotten something in return for your money. It is very hard to spend a small fortune on these and continually throw them away when they expire.
2
Two doses may be necessary in some cases, so I do not think allergy sufferers want to take the chance of only having one pen. It might contribute to the shortage, yes, but the alternative may be dangerous.
2
These patients are trained to use epi-pen for during life threating allergy attacks. probably people are not used to without epi-pen attacks . So Doctors and nurses need to educate patients what do they need to do during life threating happened.
1
You can bet that no wealthy people are doing without.
6
I have been told by my pharmacy, when filing other scripts, that the problem is the manufacturing plant in Puerto Rico is closed. That it has been closed without power for months. Since that is their supplier, they have nationwide shortages and a scramble for many new suppliers.
On EpiPens-myco-paygotso high years go, I could no longer afford them. I have stress induced idiopathic anaphalaxic reactions.
I take my chances.
GOP killing Americans daily for the cult of personality, one man, over country.
Greed, power and amorality rule.
5
Get the generic adrenaclick... or ask about the program for free auvi-q. There are other cheaper options now.
5
from the article "Administration announced there were shortages of two brands of epinephrine auto-injectors, including EpiPens, sold by the drug company Mylan, and Adrenaclick auto-injectors, made by Impax Laboratories. Another brand of epinephrine auto-injector, called Auvi-Q, is available, but may not be covered by some insurance policies."
the "other, cheaper options" are just not available now.
1
In the ER when things are moving really quickly during a code blue epinephrine will be delivered to the lungs through the breathing tube inserted during intubation for a patient who isn't breathing. It's efficacious.
Perhaps a wise pharmaceutical firm could develop a nebulizer containing epinephrine. All the talk about lack of FDA approval could be kiboshed by stating that the use in anaphylactic reactions is "off-label," one of big pharma's favorite tricks to get doctors to prescribe their meds more often.
A nebulizer with epinephrine that hasn't passed double blind clinical trials to the satisfaction of the FDA is better than a non-existent auto-injector. This is truly pathetic, our country's pursuit of the almighty dollar is turning us into a 3rd world nightmare.
8
Nebulized epi is available. I don’t know how much is systemically absorbed (I’m sure some) which would be important in vascular collapse.
4
It is available. It just isn’t effective enough for the non-respiratory systems. In an emergency hospital situation, they never give epi just via inhalation.
1
And this is why formularies are not a good way to control prices. It's also why we should ever rely upon one company for something this important whether it's a shot of injectable epinephrine, a common antibiotic, a vaccine, or anything else like IV quality saline.
For an advanced country we don't seem to have much control of our drug supplies. Could it be that the pharmaceutical industry doesn't have our best interests at heart? The same question applies to the health insurance industry.
14
Your doctor should be able to supply you with it. What's going on?
1
Is the Trump Administration winning yet?
6
Can't people just use the vials and syringes? At a school the nurse could administer it.
3
There’s no time for a nurse in these scenarios. You are talking about self administering -
3
Many people do not know how to self inject and would freeze in an emergency. If you cannot breathe or are about to pass out it’s more likely you could use an EpiPen than self inject. Many reactions happen when people are alone.
3
Epinephrine is an inexpensive drug. Keeping a syringe filled and ready to go is the solution. Are people just not thinking about plan B? Before the PEN how do you think epinephrine was injected?
The truth is that there are pre-filled syringes that sell for about $10. Of course they look like a syringe and you can see the hypodermic needle. Avoiding seeing the needle by paying hundreds of dollars per unit or get used to the fact that the EpiPen is just a syringe in disguise.
9
is that what you use for your and your children's life-threatening allergies?
1
This is another compelling argument for a federally sponsored uni-payer system of universal health care with government oversight.
***A Connecticut physician
15
Because universal healthcare without universal drug coverage ( which is the norm around the world) would solve what particular problem with EpiPens?
Canada has the exact same shortage.
Oh for god sake, this is easy.
Just tell the manufacturer that they can go ahead and charge $1,000 each for the things and watch shelves overflow.
Is the fed really too dumb to see an artificial shortage when it is staring them in the face? These things were easy to get when they were $50 each, suddenly they aren't
12
It is off patent so go out and start your manufacturing company now - and why exactly do you think no one has done that yet?
1
"Manufacturing problems" Sure, right, The pens have been manufactured for years and suddenly there are manufacturing problems? Based on the past underhanded actions of the manufacturers to extort outrageous prices for the pens, It seems to me that this is just extortion. Don't look for any meaningful investigation by the Trump Government. Trump is quite happy tht speculators are buying drug companies in order to exploit people who need those drugs.
13
My epi-pen alternative is available and refillable: https://www.nytimes.com/2017/02/28/opinion/how-to-fight-a-soaring-drug-p...
5
So after raising the price 600%, Mylan can’t even run a basic manufacturing operation properly on product that has not changed for years. Paid a $465 million fine for defrauding Medicare. Paid the chairman $100 million.
It make me so mad my son with a life threatening nut allergies is dependent on the whim of this bunch of crooked clowns and their pals in Congress.
29
Back when there was widespread outrage at Mylan's rapacious business practices, some instructions appeared online for making your own epinephrine injector for a few bucks. After all, epinephrine itself is very inexpensive. If those instructions are no longer online, I'd suggest using the Internet Archive wayback machine to track the info down.
1
For anyone capable of learning to inject insulin from a vial using a syringe, subdermal syringe injection can be done with Epinephrine. 3 vials of epinephrine and 3 syringes with needles cost less than $10 - - - though not as automatic - and training is needed to assure the correct dose and injection technique. Given auto-injector supply shortages and quality control problems, the basic syringe injection method risks seem acceptable for those who are able to be trained and would help reduce the supply shortage of the auto-injectors for those who require or prefer auto-injection.
9
Not good got Senator Joe Manchin, who’s facing a tough time in the November election: his daughter runs Mylan
9
The continued ineptitude of Mylan leadership is astounding. First they increase the price despite pushback from their own Regulatory staff. Now this manufacturing issue with an FDA letter. Not sure how Joe Manchin's daughter continues as CEO with no credentials and inexperience. Her managing the crises her leadership caused is lacking. Hmm ??? maybe Congress should investigate - yeah no. The plan seems to be let children and adults suffer. Mylan needs a shakeup now.
8
"Ineptitude" is not the word I would use. More like greed in limiting the supply.
12
Manchin's daughter is a rapacious thief.
I'm a democrat but I would not vote for him!
5
This is outrageous. And the reader from Bloomington, Indiana, is exactly right: why do we guess that Canada and the rest of the world probably has steady and affordably priced access to epinephrine? That should be the follow-up article. And one more: have immunotherapy trials expanded beyond the programs the Times has covered at Stanford and Mt. Sinai? I'm incredibly grateful that my daughter participated in one at Mt. Sinai, so though she still needed an Epipen in an incident last year, her resistance to nuts is far stronger than it was. Just in time apparently.
9
Canada is experiencing the exact same shortage
3
This article forgets to say whether the same product is easily available at a reasonable price in Canada and elsewhere around the world.
15
People should check with their physician about getting epinephrine ampoules and small syringes. If an autoinjector is not available, the allergic individual or guardian or school nurse can simply inject it, if necessary. (The technique can be practiced in advance with saline to build competence and confidence.)
Both are inexpensive and work as well as autoinjectors (and aren’t subject to failure to function as the autoinjectors are occasionally).
3
With a Rx you can get a vial of epinephrine and syringes for a small fraction of the price of one EpiPen. You have to learn the dosage and technique of injecting it but if you or your child has a life-threatening allergy that is probably something you should know anyway.
I get the convenience factor of the pen, but given the beyond-outrageous price and now problems with availability, perhaps it's time for patients to take back some power for themselves.
12
Auvi Q is NOT superior, it is price gauging. It costs over $5000 to Epi pens already overpriced over $600. This is price gauging all around.
7
Raindrop & I rec'd the Auvi Q for free, how is that price gauging? its a promotion designed to have them introduced. It's much easier for me to carry than the long pen.
3
For anyone who has commercial insurance (i.e. not a government program) OR has no insurance, the manufacturer of AuviQ has a program to send for free to your house or doctor’s office. The doctor’s office processes paperwork to AuviQ, who then verifies everything by phone. We had ours by the end of the week, and our insurance does not cover Auvi Q. At no cost.
4
Plus AuviQ is a far superior product, smaller to carry and gives you verbal instructions at time of delivery which is always in an emergency.
8
Genuinely curious: How is it that an epi pen can be perfectly fine on one day and then suddenly expire? What is the expiration date based on? What happens to unused epi pens?
19
If an Epi-pen is expired, our school won't accept it. I think they are probably fine and I wouldn't hesitate to use it an emergency, but they need to be up-to-date at school. That means a set for the classroom, a set for the cafeteria. We also keep one my son's backpack for after school play dates. With one at home, that's about $2400 of Epi-pens. Criminal pricing for simple epinephrine .
30
What's criminal is, why does every kid have to buy their own Eli-Pen? Can't the school just have 5-6? What are the chances of every kid having an allergic reaction at the same time?
3
This is a great question. The answer is that if the cause of each incident is independent, then the odds are very small, but if there is a common cause (such as accidental inclusion of nuts in an apparently nut-free food served to many children), then the odds of a common reaction are quite high. A parent should rightfully be concerned about this sort of common cause failure.
My allergist prescribed me this, and I recieved four for free. Same epinephrine dose. I'm not associated with the company or selling them.
https://www.auvi-q.com/getting-auvi-q/?utm_source=google&utm_medium=...
3
"Consolidation in the pharmaceutical world has diminished the number of manufacturing plants, so production problems at a single site can have tremendous repercussions"
The solution here is obvious -- reverse the consolidation.
In engineering, we insist that a component be available from at least two sources to prevent supply issues that would halt production.
As a condition of FDA approval, critical drugs and equipment should be available from more than one manufacturer, either as a generic or under license, and sufficient manufacturing capacity should be available to fill demand in the event one of the manufacturers is unable to supply the drug.
47
How to solve this easily and permanently : Nationalize some Pharmaceutical manufacturing Facilities. Critical, life saving and life sustaining medications MUST be available 24 /7, in every single region of the Country. This would be an outstanding part of Medicare for ALL.
Just saying.
61
The same goes for finance. Make it a public utility. Too much rent seeking going on and debt being laid on.
1
But this is America, where nothing can interfere with the God-given right to profit from every single thing no matter how important it may be to people's lives. /s/
3
Yes, but we are too broken for that. Big pharma would not allow it and they have paid off most of those in power.
1
Call me a skeptic, but maybe there's some collusion somewhere.
43
Of course there is collusion. And you can be sure that no peone in the Senate or the House will be investigating it unless one of their children with peanut allergies dies from not having a pen. Totally disgusting. And you won't hear our loud mouth President call for an investigation. But don't worry, Melania is looking out for children and is campaigning against cyber bullying while being married to the biggest cyber bully in the United States. Beyond ironic isn't it?
8