Thursday, September 22, 2016

Yes, There Should Still be Epinephrine in Our Schools

I will get right to the point. I am worried that the recent discussions on Epi-pen and Mylan Pharmaceuticals could set us back a decade on access to epinephrine.

Four years ago I wrote a piece that appeared here and on, titled, “Of Course There Should Be Epinephrine in Our Schools.” During those four years hundreds of advocates, medical professionals, and legislators have come together to ensure that there is epinephrine in our schools – a place where food is served every day and, unfortunately, where some children will have their first anaphylactic reaction.

This is progress.

And yet, I worry. Yesterday I watched a portion of the Congressional Hearings on Epi-pen pricing. What bothered me most were the questions about epinephrine in schools.

Nearly every state now has a law that allows undesignated (meaning not labeled for a specific child) epinephrine in schools, and many states require it in schools. Mylan has helped with their Epi-pen for Schools program that gives schools free Epi-pens and sells them additional pens at a discount. I assert that without this program, many of the 65000+ schools that stock undesignated epinephrine would not have it.

This is progress.

And yet, many of the senators questioning Heather Bresch at the hearings wanted to focus on how she went about getting the Epi-pens into the schools, the role her mother (who happens to be the head of the National Association of State Boards of Education) played in getting the legislation passed, and whether she was ensuring a monopoly while getting this legislation passed.

This is where it gets scary.

Heather Bresch was berated for walking down the halls of Congress to help pass legislation for undesignated epinephrine. Of all the things we can be angry about, passing this legislation should not be one of them. Yes, Mylan had a great a marketing plan to expand the market. But it was a win-win. The company expanded the market while increasing access to a life-saving drug.

Every food-allergy advocate, parent, and health care professional that I know supported these laws. Many of them worked to ensure that the wording stated “epinephrine,” to allow all types of auto-injectors (including the Auvi-Q, then on the market, and any to come in the future) to be covered under the law. Any of us would have drawn on our network (personal or otherwise) to help pass this legislation. Because it was the right thing to do.

But we’re not finished.

Yes, epinephrine still needs to be in our schools. But it also needs to be on airplanes, in ambulances, and in restaurants. Epinephrine needs to be everywhere there is a defibrillator or where food is served. Let’s not take a giant step backwards by focusing on the wrong issues.