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Anyone following the Epi pen drama?


lexi
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Why do you assume I don't want people to profit from their creations? Of course, they should profit. 

 

Ideas can't be owned. They are not tangible material goods. There are industries that feed entirely off of copying ideas and changing them, for example the fashion industry. Somehow fashion designers still make money despite the fact that cheaper copies are sold to the masses. Really it is a leap of the imagination to assume that someone can't make any money off their idea because the government is not enforcing a strict monopoly on the idea for them. 

 

I don't know anything about the fashion industry. But if I bear the cost of researching and developing a medication and bring it to market and other companies can just jump on the bandwagon and start producing it themselves, that doesn't seem right. But wouldn't that be what happens when patent laws don't exist and/or aren't enforced? A medication isn't an idea. It's a specific chemical creation. Nothing prevents other companies from creating their own cholesterol drugs or whatever. But they can't copy mine until the patent expires. Which is as it should be since they didn't bear the cost of developing it. Not having or enforcing patent laws is a great deal for the other companies, sure, and the consumer, probably. But I can't imagine any company altruistic enough to say they'll be happy to pay millions to develop it so others can copy it. Makes no sense to me. That doesn't in any way mean I think making a profit should equal gouging sick people.

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I don't buy that the issue is insurance covering it so the consumer doesn't see the price. Because in theory, the insurance company, fi they are footing the bill, should have been having a fit and negotiating the price. They had much more to lose, financially, as an entity paying for thousands of them, than any one consumer. 

 

 

I agree with this about prices. My insurance company covers one particular asthma medicine and I would have to pay $900 a month if I chose the other option if I didn't find coupons etc.  They simply don't cover it. I'm not sure their whole purpose is to get the pharmaceutical company to bring down the price but that would be my guess. 

 

I do think the amount of health care paid for can decrease when end users pay. I have chosen to go without part of my asthma drugs because of cost. I used the older drugs and flatly refused to pay for the newer ones and though I suffered for it I didn't die. Not everyone has that option. In some cases you would pay anything which is why it is dangerous to give complete monopolies to companies. There are people who will overuse services if they are free. I think that is pretty common knowledge. That is different than the cost watch that you are talking about though. Things like crutches and wheel chairs are more likely to be found used if you are paying out of pocket, etc. So many drugs get dumped in the toilet every year. Having just moved my grandmother to assisted living and having talked to the nurses I wouldn't be surprised if millions and millions of dollars of drugs are just disposed of every year when elderly move in in addition to  prescriptions that don't get finished in independent homes. 

 

 

On another note,

 

I think we can no longer call "health insurance", health insurance as people use it to pay for everything. The point of insurance is to pay for the unforeseen costs. Would I contribute to insurance that would help to pay cancer treatment that I hope never to contract? Undoubtedly, yes. Just like I pay for home  insurance in case my home burns to the ground but in general people don't have the attitude that they should get back everything they put into home insurance. There seems to be an understanding that everyone's policy payments pay for the one person's home who did burn down and that will be there for you if it happens to be your house. Somehow we lost that whole concept with health insurance although high deductible insurance could be a path to bringing that back. 

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Well...yes and no.  Insurance companies DO negotiate prices.  They actually have SET prices they will pay for X and Y and Z meds.  

 

So...wouldn't it be in their financial interest to set that price fairly low? In other words, wouldn't they have even MORE of an incentive than the consumer, to keep prices low?

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I don't know anything about the fashion industry. But if I bear the cost of researching and developing a medication and bring it to market and other companies can just jump on the bandwagon and start producing it themselves, that doesn't seem right. But wouldn't that be what happens when patent laws don't exist and/or aren't enforced? A medication isn't an idea. It's a specific chemical creation. Nothing prevents other companies from creating their own cholesterol drugs or whatever. But they can't copy mine until the patent expires. Which is as it should be since they didn't bear the cost of developing it. Not having or enforcing patent laws is a great deal for the other companies, sure, and the consumer, probably. But I can't imagine any company altruistic enough to say they'll be happy to pay millions to develop it so others can copy it. Makes no sense to me. That doesn't in any way mean I think making a profit should equal gouging sick people.

 

I don't know why you say that a medication isn't an idea. If I purchase ingredients to make the chemical formula those are tangible things that I can actually have possession of but if a chemical compound is made from them that heals or relieves than that is an idea or knowledge or fact but it is certainly not a tangible thing. What if another company found that same formula 2 days before the patent went through on the first company but they were not able to get their patent through fast enough. They did NOT get the chemical formula from the first company but it is now illegal for them to use their own knowledge.  They lose all the money that they have invested in that research and people lose out big time by having to pay monopoly prices for that drug. 

 

 

Research and development is done in a myriad of industries. Medicine is not exactly unique in that aspect. I do think research would continue under a different model as it does in other industries. I think people would pay for research even separately apart from medicine. People believing that without monopoly power all research would end is definitely something pharmaceutical companies benefit from though. 

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I have a medication I take as a migraine preventative that has gone through a similar price gouge. I started taking it when it was still under patent protection. The cost was reasonable. It was tier 1 with my insurance company. The patent ran out and a generic became available. The cost to the Pharmacy was about $20 for my one month supply, and it remained tier 1 with insurance giving me a small discount. Then the original manufacturer quit making it, I guess they weren't making enough profit to bother with any more. The generic raised their price and now the pharmacy pays over $6,000 for my one month supply. Really? They have no R&D in it! They're just grabbing money because there is no competition. Most insurance stopped covering it (according to my migraine specialist), but mine has kept coverage so far. It is the only thing that has helped my migraines significantly in almost 20 years of trying and now I will probably lose access to it. 

 

Out of control.

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Oh, touching upon the two epipen issue - people were having rebound reactions after the epinephrine wore off, and numerous people were dying en route to the hospital. The standard advice now is to have a two pack available at all times because sometimes one doesn't act long enough and in some cases the dose is insufficient

 

It wasn't just marketing - in this case it's actually evidence based (rare, I know ;) ).

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Oh, touching upon the two epipen issue - people were having rebound reactions after the epinephrine wore off, and numerous people were dying en route to the hospital. The standard advice now is to have a two pack available at all times because sometimes one doesn't act long enough and in some cases the dose is insufficient

 

It wasn't just marketing - in this case it's actually evidence based (rare, I know ;) ).

And because of the rare chance that one might be a dud for some reason.

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I don't buy that the issue is insurance covering it so the consumer doesn't see the price. Because in theory, the insurance company, fi they are footing the bill, should have been having a fit and negotiating the price. They had much more to lose, financially, as an entity paying for thousands of them, than any one consumer.

How stupid it is if them to say the patient never sees the price if they have insurance. Who the heck do they think is paying for the insurance?! The patient! They pay premiums and then they still have copay and deductible.

 

So even if they don't see the full insurance price up front, hacking the price still really hikes their OOP portion too.

Edited by Murphy101
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There is nothing wrong with medical patents. The problem is US regulation caps at distribution for patient costs. Keep in mind a huge amount of R&D is funding by the govt in various forms, so it's not like these places do all the funding themselves either. And that's not even getting into the subsidies they are given to R&D and distribute known no profit items considered vital to public good, such as some vaccines that are mostly used by the military (anthrax) or as global relief, such as medications used in third or second world countries more than here, but it's still to our benefit to help.

 

Other countries have no problem respecting patents and the concept of profit while at least trying to balance against getting necessary meds to as many people as possible for reasonable prices.

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I heard Martin Shkreli came out defending them and calling them the good guys, because most Americans are insured anyway so what does it matter? That pretty much sealed my opinion, lol. Dr Evil may not be benefiting his cause the way he thinks...

Actually a large number of people us included, have no coverage for epipens. It as an uncovered drug. Dh is allergic to bees/wasps. His epis have expired but when he went to get his refill recently he delayed because of the cost.

 

Scares me.

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You'd be surprised. Remember the information level of most consumers, as well as the spoof web portals and redirects. I can tell you that at least when it comes to inspection the more remote the pharmacy the more problems we have, from suitability of the facility for packaging (let alone manufacturing and compounding, both sterile and non-sterile preparations) to the quality of the staff. And it is regulated very differently in other countries, some better and worse.

 

The good news is that getting the domains standardized guarantees both a current list and a minimum quality standard via the inspection NABP already certifies, which are excellent and more rigorous than even those our state has adopted into regulation. Adding in reliable international pharmacies to the mix will only improve quality and access.

 

I'm well informed and I still have a personal horror story from an international pharmacy I was using. It happens more than you'd think, and they were legitimate (until they were sold, ugh).

No, I'm not saying it doesn't happen. I'm saying it is easier to avoid than not *most* of the time. And also, keep in mind some people do it on purpose for cheaper meds.

 

Last night I met a woman who was talking about how she purposely buys her medications from the same place a fishery uses. That's right, she is buying fish medication instead of human medication bc it is pennies on the dollar.

 

I told her I wouldn't do that bc while veterinary medications are safe for animals, they are held to a lower purity, potency, and safety standard than medications for humans. But she was adament it is the "same" drug and the only thing she can afford anyways no matter how much I tried to explain that no, not exactly, and possibly just enoug of a difference to make her sick, or at least not quite treat her as well. *smh*

 

Yes, I love that the walking dead had a vet and at one point they do raid a vet school for meds. In desperation. Bc apocalypse. I'd *like* to think we are not quite at the medical apocalypse juncture yet. But for some people apparently we are. ðŸ™

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Actually a large number of people us included, have no coverage for epipens. It as an uncovered drug. Dh is allergic to bees/wasps. His epis have expired but when he went to get his refill recently he delayed because of the cost.

 

Scares me.

I'm allergic to bees and scallops. No epi pen here. No insurance either.

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No, I'm not saying it doesn't happen. I'm saying it is easier to avoid than not *most* of the time. And also, keep in mind some people do it on purpose for cheaper meds.

 

Last night I met a woman who was talking about how she purposely buys her medications from the same place a fishery uses. That's right, she is buying fish medication instead of human medication bc it is pennies on the dollar.

 

I told her I wouldn't do that bc while veterinary medications are safe for animals, they are held to a lower purity, potency, and safety standard than medications for humans. But she was adament it is the "same" drug and the only thing she can afford anyways no matter how much I tried to explain that no, not exactly, and possibly just enoug of a difference to make her sick, or at least not quite treat her as well. *smh*

 

Yes, I love that the walking dead had a vet and at one point they do raid a vet school for meds. In desperation. Bc apocalypse. I'd *like* to think we are not quite at the medical apocalypse juncture yet. But for some people apparently we are. ðŸ™

 

Actually, every vet I've known uses animal meds on a regular basis. No apocalypse :) I certainly treated my own eye infection, skin issues, burns, etc with stuff I got at the vet clinics :)

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Actually a large number of people us included, have no coverage for epipens. It as an uncovered drug. Dh is allergic to bees/wasps. His epis have expired but when he went to get his refill recently he delayed because of the cost.

 

Scares me.

Oh, I absolutely agree! I'm sure there are less people insured than he would hope, and even less than that who have coverage for this particular thing with a decent co-pay.

 

I find myself automatically railing against any point Shkreli makes in any kind of argument, regardless of how much merit his opinion might have (in this case, unsurprisingly, it has very little). The man is horrid.

Edited by SproutMamaK
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WOAH, what?  Wonder what the legalities are of mailing those?  Wonder if customs would have kittens if I hop over the border and buy them?  Hmmm!!!

 

Who is going to check your purse for an Epi-Pen purchased in Canada? I think you are good. Claim NAFTA.:D

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Haha, I've never actually seen how they search at the border, because the times I've crossed, it was on military orders. We just showed our orders and they told us to have a nice day. (Others on military orders we know had to empty *everything* out of their vehicles.)

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Actually, every vet I've known uses animal meds on a regular basis. No apocalypse :) I certainly treated my own eye infection, skin issues, burns, etc with stuff I got at the vet clinics :)

But would you use it for your heart medication? Minor stuff like you mention is probably fine, in part bc even if it isn't up to human production standards, it's in small does for a brief non critic issue. That wouldn't phase me either, and I've known many a livestock owner who did the same. But I still wouldn't use livestock meds for *daily and life critical* long term medications.

Edited by Murphy101
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Haha, I've never actually seen how they search at the border, because the times I've crossed, it was on military orders. We just showed our orders and they told us to have a nice day. (Others on military orders we know had to empty *everything* out of their vehicles.)

Every time I have crossed the border, US Customs asks where we are going and how long we plan to stay, how much cash we're carrying, if we have any drugs, either recreational or prescribed with us, if we have any fruits or vegetables, or if we have any firearms or other weapons.

 

When we cross back, Canada Customs usually just asks us if we have anything to declare. If US Customs asks for declarations going back in, you would probably have to declare the epi pens.

Edited by Audrey
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I don't know why you say that a medication isn't an idea. If I purchase ingredients to make the chemical formula those are tangible things that I can actually have possession of but if a chemical compound is made from them that heals or relieves than that is an idea or knowledge or fact but it is certainly not a tangible thing. What if another company found that same formula 2 days before the patent went through on the first company but they were not able to get their patent through fast enough. They did NOT get the chemical formula from the first company but it is now illegal for them to use their own knowledge.  They lose all the money that they have invested in that research and people lose out big time by having to pay monopoly prices for that drug. 

 

 

Research and development is done in a myriad of industries. Medicine is not exactly unique in that aspect. I do think research would continue under a different model as it does in other industries. I think people would pay for research even separately apart from medicine. People believing that without monopoly power all research would end is definitely something pharmaceutical companies benefit from though. 

 

We'll have to agree to disagree then. Because we're clearly looking at this particular aspect of the issue differently. That's OK. I certainly do agree that what's happening with epi pens and some of the other meds people are talking about is ridiculous. I'd be very curious to see what the actual costs of R&D are to companies minus any gov't subsidies, etc. and compare that to what they charge.

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Every time I have crossed the border, US Customs asks where we are going and how long we plan to stay, how much cash we're carrying, if we have any drugs, either recreational or prescribed with us, if we have any fruits or vegetables, or if we have any firearms or other weapons.

 

When we cross back, Canada Customs usually just asks us if we have anything to declare. If US Customs asks for declarations going back in, you would probably have to declare the epi pens.

 

Well, boo.  Thanks for the info!

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I've said it before and I'll say it again...  fiduciary responsibility is an inherent conflict of interest in the health care system.  It might result in more drugs being developed than if there were strict price and profit controls, but when they have a legal obligation to get maximum profit for shareholders... I can't even really call the guy a criminal.  Congress has got to do something to redefine corporate responsibility in ethical situations like this.

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Exact same vial of insulin here is $180-210 a vial.

We order it from Ontario or London and get a 3 MONTH supply including shipping for <$100.

No problems.

Other than American lobbiests trying to make it illegal under BS claims the drugs are subpar. They aren't. Exact same drug. Exact same manufacturer. Exact same distributor most times too. Only difference is those other countries don't allow unethical pricing.

  

I order epipens from a Canadian pharmacy. No problems. $170 shipped for a 2-pack.

I'm so sorry if this has already been answered...

 

How does one go about ordering something shipped from Canada to the U.S.? Any respectable companies you'd trust? I order things weekly on Amazon but never heard of any Canadian drug shippers... I can just imagine the web results i'd get if I try googling it without any awareness of a respectable company.

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I don't have normal insurance, so not sure how this works, but there's a $0 co-pay savings card on the Epipen website if anyone wants to check it out https://www.epipen.com/copay%20offer?utm_medium=cpc&utm_term=epi%20pens%20at%20walmart_phrase&utm_content=drug%20store%20specific&utm_campaign=epipen%202015%20-%20branded&utm_source=google&gclid=CPHdge-Z3s4CFQ1kNwodvA4HdQ&gclsrc=ds

 

 

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Well, boo.  Thanks for the info!

Declaring them doesn't mean they'll take them away from you. You might only just have to pay taxes on them. Like we have to do with groceries or other goods. If you're close enough to the border, it would be worth looking into it. The price gouging going on is completely egregious. If you can get reasonably priced medicine, do it. We have the exact same product you would get in the US. The only difference is that the packaging and instructions will be in English and French.

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But would you use it for your heart medication? Minor stuff like you mention is probably fine, in part bc even if it isn't up to human production standards, it's in small does for a brief non critic issue. That wouldn't phase me either, and I've known many a livestock owner who did the same. But I still wouldn't use livestock meds for *daily and life critical* long term medications.

 

No, not for heart problems or what not. Although a quick search tells me that the FDA has actually the same drug protocols for human and animal meds. But dosages would be werid and if you are on heart meds you'd be seeing a doctor for it anyway. They generally use animal meds for stuff just to avoid seeing a doctor. So for a burn, skin infection, that kind of thing. There was a human doctor though that bough the animal version of glucosamine for himself, because he researched it and the animal version (cosequin) had better science and safety behind it than the human version (cosamin). 

 

I've also used animal antibiotics for a bladder infection...Cipro is Cipro. But that was at a clinic where I knew where we were buying the drug from, etc. I would be unlikely to do that ordering from some random fish store or whatever. That I'll agree with. 

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I think the epi-pen thing is an awesome example of what happens when the government controls the market.  I can't figure out how to link to this quote, but:

 

 

Company A discovers and produces a life-saving medicine. Overtime, the company’s executives realize the unique value they are providing consumers, and decide they should raise prices by 400%. Company B, Company C, and Company D are attracted to this market because of the fattened profit margins, and believe they can produce a similar product at a cheaper price, competitively providing more value to consumers than Company A. But there is a problem. You see, Company A has former employees that work at the FDA (Federal Drug Administration). They also have a big lobbying budget.

-Company B successfully develops a similar product but it has to be approved by the FDA and is stalled out in a 10-year approval process.
-Company C also develops a similar product, but find themselves in court because Congress has passed strict patent laws preventing competing products in the marketplace.
-Company D was able to replicate Company A’s product at a cheaper price as well, but the only insurance company that would cover it is based in New Hampshire, and because of Federal law, only citizens of New Hampshire can buy this insurance.

While the market aggressively tried to provide consumers with another competing alternative, Company A was well-connected enough to government bureaucrats and Congressman to protect their monopoly  [Hello, CEO's Dad, Sen Joe Manchin!]. Then, the loudest proponents of more government power Tweet out to millions of voters saying that the problem was caused by the free market, and only government can offer the solution.

 

 

 

I am seriously laughing at the suggestion of price controls, especially given the above scenario.  The government enables a monopoly and then everyone is surprised when a huge profit is made by one company?  Really?  I really think a class in basic economics should be a requirement these days for high school.  What happens when you institute price controls?  The laws of supply and demand don't vanish into the ether because an item happens to be a medical device.

 

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Playing devil's advocate here, but if you don't want people and companies to profit* from their creations, what incentive is there for them to invest in doing it in the first place?

 

 

*not saying current profit levels are reasonable

 

ETA: If you're going to do away with patent law, that's not just going to affect medications.

 

If we got rid of or weakened various intellectual property laws, it would affect quite a few industries, and for a while I think it could have some bad effects. 

 

But I think it's possible it might actually be better once things adjusted.  As frogger pointed out, these kinds of laws don't apply in every industry and some of them still manage to make money.  And - really intellectual property laws are pretty recent, and we did manage before that.

 

One thing people always talk about, especially with drugs, is how would we fund research without profits to drug companies.  One possibility is that rather than consumers funding private companies, we could have taxes funding research - it's still the same money, there is no reason it would cost more and in fact could very well cost less. In fact government used to spend a lot more than they used to on R&D, and the change in emphasis from public funds in universities being the main focus for research to it being private companies doing/paying for it has been seen as generally very negative.

 

THis would possibly mitigate a lot of problems that we see with private drug companies - the whole take an old drug and monopolize it change it for profit for example.  There would be little value in promoting drugs that do nothing or suppressing research.  And research could be based on what people really need and what scientists think would be most useful, rather than on things that will make the company a lot of money but are not so important in human terms.

 

In the case of things we don't want to subsidize through government, say, iphones, it might be that the technology moves more slowly than it does now.  But, this might not be a bad thing either - fast moving technology makes it hard to evaluate negative social costs, and it also can tend to be less environmentally conscious.

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And the company has said it's going to offer more coupons. (Not lower prices as they've been asked to do).

Coupons are only a feel-good thing. They won't help the masses of middle class folks who won't qualify. The price should be lowered, period. Why in the heck would companies raise the price so dramatically for a long-existing product? One reason, pure and simple, and that is greed. They do it because they can.

 

ETA: Adding here, that these exponential price increases in highly critical EXISTING drugs seems to be a new thing. I have no problem with companies initially charging a high price for a drug they have just entered on the market. But for a drug that's been around a long time, I find these kind of price hikes inexcusable.

Edited by Serenade
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Every one of these drugs companies get HUGE amounts of money from the govt for research and development and subsidies, with almost zero requirement to make the end product affordable for anyone, much less everyone. And they can set the price however they want. It's nuts.

 

The coupons are freaking joke to give them good PR while not actually holding them accountable.

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Also, one aspect I haven't seen mentioned....these things expire annually.  Which means, even if a person NEVER needs it within a year....they still have to buy a new one (or more) each year.  Now, I know that food expiration dates are VERY conservative.  I assume, since the FDA does both food and drugs, that the drug expiration dates are also conservative.  Knowing that drug companies also have big lobbies, I can't help but wonder if the 1 yr expiration date doesn't have as much, if not more, to do with ensuring a steady purchase rate, as it does with ACTUALL effectiveness.

We were told by pharmacists that the dpi-pen is good as long as the liquid is still clear.

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We were told by pharmacists that the dpi-pen is good as long as the liquid is still clear.

 

Yes, we've heard the same thing but we've heard that we need to replace yearly also, from the allergist.    She also insists that we have at least 2, so that if the ambulance is delayed, we can inject again in 15 minutes.  And if we're far from a hospital, she wants us to have enough to get to a hospital - re-injecting as needed till we can get to help or help can get to us.  Since it's life or death, for our child, we go with refilling but I totally understand saving old epipens.  

 

We also have a sad tendency to leave our epipen cases in hot cars, or cold cars, overnight - and they have to be replaced then as well.  Theoretically if the liquid is still clear, it's okay, but we are talking about life or death, so we err on the side of caution.  ...Or there was the time DS dropped his case in a Target parking lot, and watched in horror as a car *ran over* it.   :crying:

 

If the meds are good for longer than a year, they need to put a more reasonable expiration date on the pens.  I don't mean the date put on by the pharmacist, which is one year from the date of filling the pen, but the date stamped on by the manufacturer - that's the exp date we always check when we get the pen (sometimes it's less than a year from the date of filling, so we ask to exchange it!).

 

When we started getting epipens, in 2006, we could still buy singles epipens (though the allergist insisted we have 2 at all times), and the cost was very low - around $100.  It's $600 for a 2-pack now, here.  We have a high deductible, so we are very aware of the cost of all meds.  It was even worse, because, literally, the night before the Auvi-Q recall - we had filled 6 of them.   SIX.   :scared:  :svengo: It was to go on vacation.  Within 24 hours they were recalled.  What a nightmare that was.  We did get them replaced with regular epipens, but ouch.

 

Interestingly, we went to an amusement park a few nights ago, and the security guard who did our bag check started talking about seeing the news stories about the expense of epipens.  I'm glad it's getting attention!

 

One other random thought:  not all ambulances carry epinephrine.  It was one of the things we learned from our allergist - when we travel, we need to be aware that different areas will have different supplies on the ambulance.  Where we live, we have to tell 911 that we have used the epi, and may need more on the way to the hospital.  Even so, the ambulance has arrived to our home *without* epinephrine.  For us, we have extras - that means I ride along and epi if needed, administering myself.   I wonder if the reason all ambulances don't carry it is cost?  Because to have epinephrine on *every* ambulance seems a basic need.

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I always save the old epipens and have them as our home set (i.e., really my purse set) and I do keep an eye on the color - they usually last well more than one year but getting toward two years is iffy - that just depends.  However, the set that goes to school absolutely must not be expired - they won't take it if it will expire soon or sometimes even if it will expire late in the school year - so we have to buy at least once per year, in the summer.  I'm guessing that's why this became so noticeable right now, because everyone's refilling for the new school year.

 

Speaking of refilling, a refillable injector would be very cool.

Edited by wapiti
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One other random thought: not all ambulances carry epinephrine. It was one of the things we learned from our allergist - when we travel, we need to be aware that different areas will have different supplies on the ambulance. Where we live, we have to tell 911 that we have used the epi, and may need more on the way to the hospital. Even so, the ambulance has arrived to our home *without* epinephrine. For us, we have extras - that means I ride along and epi if needed, administering myself. I wonder if the reason all ambulances don't carry it is cost? Because to have epinephrine on *every* ambulance seems a basic need.

Wow, I had no idea this was the case. I would have expected every ambulance to have one.

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Wow, I had no idea this was the case. I would have expected every ambulance to have one.

Yes, I was shocked.

 

It varies by state, I think - but possibly by hospital. I'm not sure which anymore. We just keep enough epinephrine to keep an elephant going till we get to a hospital, these days.

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One other random thought:  not all ambulances carry epinephrine.  It was one of the things we learned from our allergist - when we travel, we need to be aware that different areas will have different supplies on the ambulance.  Where we live, we have to tell 911 that we have used the epi, and may need more on the way to the hospital.  Even so, the ambulance has arrived to our home *without* epinephrine.  For us, we have extras - that means I ride along and epi if needed, administering myself.   I wonder if the reason all ambulances don't carry it is cost?  Because to have epinephrine on *every* ambulance seems a basic need.

 

My brother is a firefighter/emt and his department has recently gone from epipens to ampules of epinephrine and regular syringes due to cost. 

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I'm surprised that ambulances wouldn't have epi on board.  It is one the of cheapest meds out there and is a main line drug in ACLS cardiac arrest logarithm (national training program used by everyone in medical pretty much).     I would think an ambulance  would have that onboard and know how to use it.  It is a life saving drug and not just for allergies.  cardiac arrest and other conditions are given epi as standard course. I wonder if it is different state to state as to what EMT can give. i always thought that was pretty standard and had federal oversight.  (dont' know why I thought that)  I'm surprised by the number of people who report they have to use their personally owned second one. I'm at the hospital or 911 is here by the time I need more doses.   That's scary to think that many  people are not close enough to a medical facility or have a robust 911 service around.    You would think in that case, ambulances (emt) would be more even more capable/allowed/required/trained/stocked to handle life threatening emergencies of any kind. They are the front line.  

 

Epi comes in several modes.  You can have it in ampule that you break open, pull up into a syringe and inject (code cart is this way) or you can have it in a cartridge that you pop onto the delivery device and inject( some code carts have this).   and then you have the auto injectors.  So a refillable method shouldn't be hard to create.

 

Though this thread has depressed me a little to think that so many feel the general public can't pop a top and stab somebody in the leg.   My life depended on the general public knowing to recognize a red tin, pop it open, fill it and inject it.   I don't remember my mom being freaked out about that.  Maybe she was.  I know everyone I ran into knew how to inject me.  Even my friends knew how.

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One other random thought:  not all ambulances carry epinephrine.  It was one of the things we learned from our allergist - when we travel, we need to be aware that different areas will have different supplies on the ambulance.  Where we live, we have to tell 911 that we have used the epi, and may need more on the way to the hospital.  Even so, the ambulance has arrived to our home *without* epinephrine.  For us, we have extras - that means I ride along and epi if needed, administering myself.   I wonder if the reason all ambulances don't carry it is cost?  Because to have epinephrine on *every* ambulance seems a basic need.

 

 

It may be a matter of the staffing...paramedics can give meds but not all people driving ambulances are paramedics. 

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Declaring them doesn't mean they'll take them away from you. You might only just have to pay taxes on them. Like we have to do with groceries or other goods. If you're close enough to the border, it would be worth looking into it. The price gouging going on is completely egregious. If you can get reasonably priced medicine, do it. We have the exact same product you would get in the US. The only difference is that the packaging and instructions will be in English and French.

 

It was more the no prescription needed thing...Canada may not require a prescription, but the US does.

 

One other random thought:  not all ambulances carry epinephrine.  It was one of the things we learned from our allergist - when we travel, we need to be aware that different areas will have different supplies on the ambulance.  Where we live, we have to tell 911 that we have used the epi, and may need more on the way to the hospital.  Even so, the ambulance has arrived to our home *without* epinephrine.  For us, we have extras - that means I ride along and epi if needed, administering myself.   I wonder if the reason all ambulances don't carry it is cost?  Because to have epinephrine on *every* ambulance seems a basic need.

 

Back in 2001, we lived in duplex military housing in Alabama.  The other half of our duplex was a family who homeschooled and one of their daughters had many severe allergies, and wore an epipen fanny case at all times.  Across the street, another neighbor's DS4 developed a severe peanut allergy very quickly.  Doc for whatever reason wouldn't give an epipen.  One day, the 4 year old went into anaphylactic shock, they called 911.  Ambulance got there quickly, and said they didn't have epi on board, it wasn't allowed.  Thankfully, the moment everything started happening, the 4 year old's mom went outside and started yelling....fortunately the HS'ing neighbor heard and she used her daughter's epi when the medics said they didn't have it.  We were fairly rural, I've no doubt that kiddo would have died in the time it took to get to a hospital.  (And yes, he came home from the ER with a script for epipens!)

 

I don't believe it's allowed on ambulances in AL even now, as I remember when my son was renewing his EMT that he mentioned something about it.

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Oh, speaking of EpiPens, my allergy kid got a job today!!!!  We are looking for some kind of obvious wearable case for him, anyone have recommendations?  He'll be working in a food court, and nearby restaurants do serve seafood, but his does not.  I don't think he can wear a bracelet while he's working (can't remember, I've been out of food service a long time), so we thought a case he could wear on his hip that was clearly medical would be good?  Anyway, the one holster on Amazon seems to have weak clips that break, so I'd love a tried and true recommendation, or even a small fanny pack type?

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Catalytic, that story made me tear up. I'm glad he's ok!

 

We have KozyEpi cases and love them. They are insulated and very durable. The epibelts are nice but wear out fast. The leg holsters are on sale... I found a link to those through this month's Allergic Living Magazine online. I'll try to come back and link. It was a few days ago. Here it is: http://www.omaxcare.com/ I haven't tried them yet, but thinking of it. The kozyepis have been the longest lasting and best we've used, but we keep trying different styles, as the fanny pack is a bit bulky for a12 year old when loaded with epipens and inhalers and spacers. :(

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A question, since this topic is hot right now, 

 

For those of you in states that do not allow EMTs to have epi on board and to give it, why not bring attention to that and get the laws changed?  Other states allow it.   Surely there are enough parents in your state to gather at the state house, letter campaign, etc to get it looked into and try to make changes.  

 

Scary to me as I never would have realized other states would not have epi on board.   I will have to check from this point forward when I travel.  Never occurred to me before.  It is a basic life saving drug.  Why in the world would an ambulance or first responder not have it???????  I was SEVEN learning how to give myself epi..........Why can't trained responders????

 

It would be awesome if this Epipen issue could at least change that.

 

Edited by Supertechmom
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Catalytic, that story made me tear up. I'm glad he's ok!

 

We have KozyEpi cases and love them. They are insulated and very durable. The epibelts are nice but wear out fast. The leg holsters are on sale... I found a link to those through this month's Allergic Living Magazine online. I'll try to come back and link. It was a few days ago. Here it is: http://www.omaxcare.com/ I haven't tried them yet, but thinking of it. The kozyepis have been the longest lasting and best we've used, but we keep trying different styles, as the fanny pack is a bit bulky for a12 year old when loaded with epipens and inhalers and spacers. :(

 

Worried about the leg thing, that maybe someone wouldn't find it in an emergency?  (We have never had to use his Epi so I have no idea how fast he could go down.  He doesn't have to have an inhaler.  Once his reactions got to the point of swelling lips and throat, we got super vigilant about avoiding it.  We also predose Benadryl whenever we go somewhere that has shellfish in the vicinity.  Sounds bad we didn't avoid it before the swelling, but we didn't really pinpoint it was an allergy until that point.  We just thought he was overeating at Benihana when we would go, and that was making him vomit in the car every time we left, ugh.)

 

I ordered a belt holster from Amazon before I thought to ask here, but it gets quite a few reviews saying the belt clip falls off, so I'd like another option.  That KozyEpi belt looks like it would work well for him, I'll just order a few for spares LOL.  THANK YOU!

 

(And that neighbor kid is 17 now, he and my allergy kid are the same age, but we didn't know about DS' allergies until he was about 8)

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A question, since this topic is hot right now, 

 

For those of you in states that do not allow EMTs to have epi on board and to give it, why not bring attention to that and get the laws changed?  Other states allow it.   Surely there are enough parents in your state to gather at the state house, letter campaign, etc to get it looked into and try to make changes.  

 

Scary to me as I never would have realized other states would not have epi on board.   I will have to check from this point forward when I travel.  Never occurred to me before.  It is a basic life saving drug.  Why in the world would an ambulance or first responder not have it???????  I was SEVEN learning how to give myself epi..........Why can't trained responders????

 

It would be awesome if this Epipen issue could at least change that.

 

IIRC, if YOU have an EpiPen, the first responders in AL can use it, they just can't carry it.  I was told the reasoning at one point and have forgotten it.  I'm not currently in AL to mess with fighting about it, that state has so many issues it's not even funny.  Found a link:  https://books.google.com/books?id=dH3PoVcw2ykC&pg=PA78&lpg=PA78&dq=do+ambulances+in+alabama+have+epinephrine&source=bl&ots=wJ-geaPfaW&sig=EwFIrGdJVYZ1N6HfV59myh4gPuU&hl=en&sa=X&ved=0ahUKEwi4x8-X9d_OAhWEqR4KHQH4CWEQ6AEINjAE#v=onepage&q=do%20ambulances%20in%20alabama%20have%20epinephrine&f=false that lists the 7 states (as of 2006) that did not carry epi on ambulances.

 

It's really rather depressing, because peanuts are huge in AL.

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But that is scary.....what if you don't have an epi? What if you used your and need a second or third dose in the ambulance? My kid is there now in the state.....and what if he needs an epi? There is always that very first time when you don't know you need it. All those people are just put of luck if they think Emts can help. How depressing to think the pt will get bagged, airway and chest compressions until somebody finds some epi. When a single dose of epi could have prevented all of that. That is just unnerving......I'm not instate to muster a challenge either......

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