Waterloo Region Record

U.S. EpiPen price hike won’t impact Cadada

- Sheryl Ubelacker

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 twosyringe 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.

 ?? JOE RAEDLE, GETTY IMAGES ?? Mylan said that more than half the amount paid by the health care system for EpiPens goes to pharmacy benefit managers, insurers, wholesaler­s and pharmacy retailers, not to the company itself.
JOE RAEDLE, GETTY IMAGES Mylan said that more than half the amount paid by the health care system for EpiPens goes to pharmacy benefit managers, insurers, wholesaler­s and pharmacy retailers, not to the company itself.

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