Anaphylaxis cost-effectiveness of therapy

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


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]


  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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