With an eye on the food allergy community as a unique group of consumers since 2008, we're on a quest to find and share ways to continue enjoying the good things in life.

17 August 2018

Food Allergy News: No One is Talking About Kaiser Permanente & Adrenaclick

Image courtesy of A.P. 
**UPDATE: I shared this post and what I knew with Julie Watts on August 17 and am thrilled she took on the story. It was the lead story at 5 o'clock that day. Here is a link to the newstory on 5WPIX in San Francisco.**

While the food allergy community is focused on the shortage of Epi-pens and yesterday's welcome announcement from the FDA regarding approval of Teva's generic epinephrine auto-injector, no one is talking about how Kaiser Permanente is handling the shortage and they should be! Kaiser provides for Adrenaclick or the generic Adrenaclick, not Epi-pen.  Over the past few months, mothers of children with food allergies have posting in food allergy support groups on Facebook about receiving only a single epinephrine auto-injector (EAI) when they filled their child's prescription at the Kaiser pharmacy. They are told they can only receive one due to the shortage but can return in 3 or so weeks to obtain a second single EAI. One patient I was in touch with informed me not only did she receive a single EAI, she was given a trainer for an Epi-pen, not the generic Adrenaclick . Note that Adrenaclick does not function like an Epi-pen; it has two caps that need to be removed instead of one.

This practice flies in the face of recommendations in the Guidelines for the Diagnosis and Management of Food Allergy in the United States (see page 28) which were issued by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health and the U.S. Department of Health and Human Services. Many allergists recommend carrying two doses and public schools in many locations require that children who have life threatening allergies provide two doses to the school nurse, not one single dose. Several studies have been done that indicate that 20-30% of anaphylactic emergencies require a second dose. 

While patients filling Epi-pen prescriptions are having difficulty obtaining their EAI's due to the shortage, pharmacies fill those prescription with an entire 2-pak. It's difficult to understand how Kaiser can justify rationing their Adrenaclick or generic Adrenaclick EAI's. 

I contacted Kaiser and here is the statement they provided: 

"Kaiser Permanente Statement
Permanente is committed to delivering high-quality, safe care for our members. We are aware of and have been monitoring the national shortage of epinephrine auto-injectors. Because of the shortage, Kaiser Permanente pharmacies will provide no more than one syringe at a time, at a member’s normal copayment. By doing this we hope to preserve supplies for all Kaiser Permanente members who need this medication until supplies become normal again."

It would seem anyone with a prescription for an EAI and a life threatening allergy would qualify as having a "documented need" and should therefore be provided the recommended and prescribed two doses. I hate to think what would happen if a patient had an anaphylactic reaction and had only one single EAI due to Kaiser's rationing and needed a second dose. It seems a formula for disaster. 

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