Did you know that in some states a Pharmacist might be authorized to give you the new generic epinephrine auto-injector instead of the EpiPen® your physician requested? I know I just posted about this topic, Epinephrine Auto-Injector Confusion Explained, on Friday and now focusing again on this topic, but the reality is that we may place our loved ones in danger if we are not educated on this topic. EpiPen®)published this highly valuable piece that I think all of us need should consider reviewing: EpiPen®.
image courtesy of Kids With Food Allergies
Our bottom line is that if we ask for an EpiPen® we want the EpiPen®! My family has been trained to use the EpiPen® and I do not want any surprises during an emergency.
Please Share this important information with fellow Epinephrine Auto-injector carrying types!
One of the hardest things I find about managing both life threatening food allergies and asthma is talking to others. I hate to be the one that might be perceived as demanding, pushing or for asking too much. What I now know, fourteen years later, is that honest, clear information presented with kindness works!..
Here’s the real kicker, Caroline. As I’ve recently found out, my pharmacist has had to get overrides a lot (especially in the last few months) because my kids’ insurance has not wanted to pay for the scripts, normally because the doctor perscribed a liquid and they don’t authorize liquids (and sometimes not even chewables) in kids age 5 or 6 and older more often than not no matter what size the pill – true story.
The overrides are easy enough to get (normally just a phone call) but they do take time…which some pharmacies/pharmacists don’t like to take, hence the reason why (when I didn’t have my regular pharmacist), I got a different script without the pharmacist telling me he was filling it differently and despite them never calling the doctor about it. This also explains why years ago I got a generic and all out total different pill from a pharmacist years ago instead of the DAW med I was SUPPOSED to get.
I fear that the same thing will happen with the auto-injectors…Even with the DAW on the script for a lot of people. Why? Because a well-meaning pharmacist wants you to get the meds you need but either doesn’t want to take the time to get the override or tried and failed and doesn’t want to have you pay for the other. I, personally, would rather have the option of paying out of pocket in that kind of situation rather than having an insurance company or a pharmacy tell me that “it’s just as good” because that’s not the point. There may be an allergy they don’t know of, there may be an issue of not being able to work the other device, etc.
At any rate, it is so important that you have a good relationship with your pharmacist and go to one you can talk to and trust. That’s as important as going to a doctor you can trust in my book. This is why that I only go to one pharmacy in particular for certain types of scripts and call one pharmacist in particular with any questions on medications – I simply trust no one else like I do him.
Good article, Caroline, and I will make sure to pass it along, too. 🙂
I was JUST telling the members of our support group about this, yesterday! If I order an Auvi-Q, I better get an Auvi-Q and you bet I’ll be checking my bag before driving away from the pharmacy drive-thru window! 🙂
I totally agree, Julie, we need to go with a pharmacy that we trust.
It’s also a process with many “points of failure” – I have to make sure the allergist/medicine refill staff member writes down the right auto-injector with the “do not substitute” note, then I have to make sure they write down the right quantity (getting them to understand that two “sets” means 4 total auto-injectors, etc.), then getting the pharmacist to understand what I want, and not substitute with a generic. I used to trust what I was given and go on my way, but now I drive around the side of the building and check my bag, before going home.
Theoretically, the generic EAI is only the generic for the Adrenaclick, so as long as I am not prescribed that, hopefully I won’t have a problem when it comes time to refill my prescription. I need to look up the rules for Texas on substituting generics for other brands.
Julie,
That exact thing happened to me before too!!! The doctor ordered one type of asthma med and then my pharmacist automatically replaced it with the generic and didn’t say a word until I was examining the package. Thankfully, I didn’t have my dad pick up the prescription as I someone do.
This is a very important point. We need to spread the word and keep talking about this!
Caroline, Dr. McKnight was just talking about this during our Walk meeting yesterday. I told him how you are helping get the word out. He was happy to hear how you take the time, do your research, and know your stuff! Also, Adrenaclick will not be at our walk, only Sanofi & Mylan. I also passed the info to CCSD last week. Keep up the good work!!
Hi Dana,
In theory, from what I understand the generic is specifically for the Adrenaclick, but I can easily see where the confusion might lay.
I think we all need to keep this conversation going and share loudly. I’m glad Dr. McKnight is all over this!
Caroline
Hi Selena,
Yes! We are going to need to be very diligent and hope that the reality is that pharmacists will only substitute for the Andrenaclick when appropriate, but alas they are human too and this is quite confusing.
I totally agree! I will be checking my bag at my next refill!
I got some more information, this morning, and wrote a little post about it:
http://www.amazingandatopic.com/2013/06/generic-epinephrine-auto-injector.html
It looks like the Auvi-Q might have some protection against substitution, but I’ll know that for sure when it comes time for a refill in August! :O
It also appears that the pricing for the generic is less than half the list price of the current brand name offerings.
Thanks Selena! In theory, the genetic should only replace the Adrenaclick but in reality confusion could be king. Best to be informed.
Thanks for sharing your post! Love ya!
I’ve really enjoyed reading your blog posts. I thought you might be interested in this study that came out a few days ago in the medical literature regarding a technique to obtain 3 or more doses of epinephrine from an expired EpiPen. While not recommended for routine use, this might make the difference between life and death in an episode of anaphylaxis that is not fully treated with the single dose of epinephrine administered by one or two EpiPens.
http://www.wemjournal.org/article/S1080-6032(13)00094-X/fulltext
Seth,
Thank you for sharing! I will check out the article.
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