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Limited EpiPen Supply: Microcosm of the Drug Shortage Epidemic

Posted by Dr. Brita Hansen on Jun 28, 2019 11:45:00 AM
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June 28, 2019 As summer weather and family vacations beckon more people outdoors, the ongoing shortage of EpiPens poses a serious risk for people allergic to insect bites. EpiPen, the leading brand of epinephrine auto-injectors, provides emergency treatment for life-threatening allergic reactions to stings, foods, drugs and other substances.

The lack of EpiPens is yet another patient safety risk brought on by ongoing drug shortages. The medication saves lives by rapidly improving breathing, stimulating the heart, raising blood pressure and reducing swelling of the face, lips and throat. The EpiPen shortage, which has lasted more than a year, produces increasing anxiety among people with severe allergies and those who care for them.

Lack of transparency

What caused the shortage of such an important medication and why does it persist? Those questions remain largely unanswered. Mylan, which distributes EpiPens, says manufacturing delays are the main reason there aren’t enough EpiPens to go around, but details are scarce. Mylan also previously weathered outrage for raising the price of EpiPens 400%.

Meridian Medical Technologies, the Pfizer subsidiary that manufactures EpiPen and its generic version, already is under investigation by regulators for not properly investigating quality issues related to patient deaths.

Alternatives

While EpiPen isn’t the only auto-injection device on the market, it’s the most well-known version. Teachers and caregivers, for example, are most frequently trained to administer epinephrine using EpiPens, making them less familiar with ― and less comfortable using ― alternative brands. Each type of auto-injector may dispense the medication differently.

Unfortunately, many generic versions don’t come with a demonstrator, so patients and caregivers may not understand how to use them in an emergency.

Another option to treat allergic reactions is to administer epinephrine using a syringe. While doctors and nurses may be comfortable doing so, it’s not always easy for others to get the dosage right. This option may make sense in a medical setting but is less practical outside of a hospital or doctor’s office. The fact that auto-injectors make it possible to administer a predefined dose with one hand makes it the fastest and most fool-proof delivery method. This can be a life-saver when a dose is needed on a playground, at a park or other non-medical setting.

Managing limited supply

Mylan and Pfizer released a statement advising a four-month extension of expiration dates on both EpiPen and the authorized generic version in response to the shortage. That’s one way to help stretch the limited supply. What can hospitals and clinics do manage through a drug shortage? Here are a few strategies hospitals are using to keep their patients safe:

  • Protect limited supplies of life-saving medications for critical patients
  • Provide guidance about accurate dosing for alternative medications
  • Understand patient populations and prescribing patterns
  • Implement temporary guidelines and usage restrictions during a shortage

The lack of EpiPen supply is just one example of how shortages are putting patient care at risk. Hospitals and health systems are being forced to turn away patients or cancel services for patients due to many shortages they’re managing every day. But by controlling the demand and utilizing clinical data to understand care delivery, they can better understand how to manage through the shortage and deliver the highest level of care required by their patients.

 

Hospitals across the country looking for an easier way to manage limited supply and gain better visibility into details and clinical context surrounding a shortage are turning to The Drug Shortage App from LogicStream Health™. The app allows hospitals to mitigate the impact of shortages and manage them more efficiently when they can’t be avoided. By using the app to better manage their shortages, hospitals can also minimize disruptions to patient care when pharmacy teams have the necessary visibility into ordering, prescribing and dispensing practices to take control of medications in short supply.

 

Learn more about what this solution can do to help your organization by downloading an overview of The Drug Shortage App at www.thedrugshortageapp.com.

 

 

Brita Hansen, M.D., is Chief Medical Officer of LogicStream Health. She began her career as an internal medicine hospitalist physician after receiving her undergraduate degree at NYU and her Doctorate of Medicine from the University of Minnesota School of Medicine. She served as Chief Health Information Officer for the Hennepin County Medical Center before joining LogicStream Health.

Topics: Drug Shortages, "Pharmacy"

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Brita Hansen, MD, is Chief Medical Officer at LogicStream Health. Dr. Hansen is also a practicing internal medicine hospitalist and has served as a healthcare system executive, most recently as Chief Health Information Officer at Hennepin County Medical Center in Minneapolis. Dr. Brita’s Blog covers a range of topics, including:

  • Appropriate Utilization
  • Clinician Engagement
  • Clinical Process Performance & Improvement
  • Healthcare Information Software & Technology
  • EHR Optimization
  • Clinical Decision Support
  • Healthcare Patient Safety & Quality

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