It’s a small but critical item in any sports trainer’s First Aid box and now that it’s in short supply, youth athletes’ lives could be on the line – particularly as schools open and fall sports start up.
A critical shortage of EpiPens, first reported in May, has yet to be resolved, according to a recent report in CNN. EpiPens are devices made to deliver the lifesaving drug epinephrine during emergency treatment of serious allergic reactions, including anaphylaxis.
The US Food and Drug Administration added EpiPen 0.3 mg and EpiPen Jr 0.15 mg Auto-Injectors as well as generic versions of these products to its drug shortages list before Memorial Day but so far, supplies remain short and some parents are relying on expired versions of the equipment, says a report in MoneyWatch. CNBC notes that sales of EpiPens typically spike in August when parents buy multiple packages to give to kids' teachers, nurses and sports teams.
While manufacturers claim the drug is still potent up to four years after its expiration date, that does little to reassure parents whose children have been newly diagnosed with allergies that require immediate intervention in order to prevent fatalities.
Compounding the problem is the already high cost. The price of the auto-injection devices has gone up 400 percent since 2007, drawing the ire of patients who rely on them to quickly counter life-threatening reactions. Outrage grew as more insurance providers dropped coverage of the EpiPen. Amid the mounting criticism, manufacturer Mylan developed a cheaper generic alternative priced at $300 for two pens.
CBS News has noted that while not everyone with allergies carries medicine to guard against anaphylactic shock, a severe reaction to food allergies or bee stings, nearly 6 million children have food allergies of some type in the United States, according to Food Allergy Research & Education (FARE). In an alert on the shortage, the advocacy group advised using an expired dose and then calling 911 for follow up medical treatment.
Owners of sports events, venue operators and others rely on trainers and other personnel to use such equipment when youth athletes suffer adverse reactions. The short supply, therefore, poses an enormous threat – particularly as kids head back to school, often necessitating the presence of EpiPens in not only there but in the bags they carry to sports and other activities.
“We are concerned that the shortage has not gone away,” said Jen Madsen, FARE’s chief of staff and senior director of federal advocacy. “We were certainly hoping it would be fixed by now, and it’s not, which is unfortunate.”
It’s not the first time Mylan has faced problems with the EpiPen, says CNBC. In 2017, hundreds of complaints were filed about the device misfiring when patients tried to use it. The FDA accused Mylan of failing to investigate those reports about problems administering the drug during life-threatening emergencies, including some cases in which people later died.
The problem devices were traced to the same facility that produced EpiPen lots which were subject to a recall early in 2017 after two reports of the auto-injector devices misfiring.
So setting aside all the red tape, what can event organizers and venue owners do to try to minimize risk that comes as a result of the shortage?
If on-site First Aid kits or trainers' equipment typically contain EpiPens, check available supplies and make sure an adequate supply is on hand
Inspect all EpiPens you find, says Dr. Lee Cantrell, professor of medicine and pharmacy at the University of California, San Diego. Every pen has a small window where the liquid medication can be seen. It's usually clear and colorless. The quickest and easiest indication that the drug has expired is a color change to brownish-yellow. " If it's discolored, you shouldn't use them, period," Cantrell warned. When exposed to light, heat or air, the epinephrine can degrade and lose its effectiveness.
Make sure athletes and their parents (and any spectators) know to bring any EpiPens (and of course, any other medication they may need regularly), rather than relying on on-site personnel to have it in stock. Registration materials should contain appropriate language as well.
SDM will continue to follow this evolving issue.