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Comment on US FDA approves nasal spray alternative to EpiPen for allergic reactions

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ARS Pharma will offer neffy at a price of $199 for two doses via digital pharmacy sites like BlinkRx and GoodRx for eligible patients whose insurance plans do not cover neffy. Some commercially insured patients can access the treatment at $25 for each filled prescription of two single-use neffy devices through a co-pay savings program.

This is considerably lower than the non-insured cost of an Epi-Pen or generic equivalent[0]. Hopefully this spurs some competition and makes the whole market more affordable. I needed to use an Epi-pen in college, and though I never took issue with needles I'm glad than an alternative is available for those fearful of them.

(I didn't feel it. I was about to pass out. But I remember looking up from the floor while administering and seeing my RA terrified. He was so scared of needles that if I had lost consciousness, he wouldn't have administered for me!)

[0]https://www.talktomira.com/post/how-much-does-an-epipen-cost

swecaOP

Not only is it cheaper, but you need to replace it much less as its shelf life is 30 months[0], compared to Epipens which are recommended every year of shelf life.

[0]: https://ir.ars-pharma.com/news-releases/news-release-details...

This is HUGE for kids. Nasal spray as a delivery method is a big step up from needles, the shelf life is much longer, it's less susceptible to high/low temperatures, and if the promotional pricing is accurate, it's cheaper than EpiPens and Auvi-Q (which talks you through the injection procedure).

I wouldn't be surprised, though, if insurers continue to push generic epinephine injectors ($15-$30) merely from a cost perspective.

swecaOP

Hmm... Canada had something like Auvi-Q called Allerject but it was recalled due to mechanical malfunctions.

https://www.cbc.ca/news/health/epipen-shortage-canada-1.3296...

It's available again, I have two that I bought this year.

The cheapest generic is $110 without insurance at CVS for two doses.

https://www.cvs.com/content/epipen-alternative

(Sometimes you could need two doses in the event of an emergency, according to doctors.)

I know this because I've been buying them for years without use (thankfully), on the off chance my son has a life threatening reaction to eggs.

Wow, this is incredible news! I had no idea this was available.

I knew someone that was… violently, ridiculously afraid of needles and to have them describe the time they had to stab a roommate with an Epi-Pen — after running outside and failing to find a Good Samaritan to do it — it was like hearing someone describe finding the courage to take a life or something, some kind of war story. He did finally do it, though. He also puked on the person.

The guy had some kind of natural aversion combined with an apparently traumatic memory from childhood of being held down and poked multiple times (probably due to their resisting) by nurses.

Agree. I didn't even think about it before in that context, but I also have some childhood trauma from too many blood tests. I can pass out after having blood drawn now and don't know if I'd be able to inject someone. Hopefully yes...

I'm convinced a lot of "antivaxxery" is simply redirected needle phobia.

Possibly. I wonder what keeps us from adopting needle-free vaccinations. It seems like the tech has been available but not fully developed for decades.

We shouldn’t be dismissive about how sub-optimal it is that children are routinely held down and stabbed, against their protests, by authority figures. There’s nothing surprising about people growing up from this and not trusting medical experts.

It depends, historically vaccines have been administered by injecting dead bacteria/organic matter that triggers your auto immune system to start generating the anti-bodies needed to fight whatever is being vaccinated against.

Irrelevant to the topic, COVID vaccines were developed with new technology that uses synthetic materials.

I am over simplifying a lot here, but the point is that sometimes you need to get that dead matter into the bloodstream to start the auto-immune processes.

Historically, yes, but these days it seems more like a question of priorities.

To your point, it does depend: there are needle-free options available for some vaccinations currently, though in many cases children are nonetheless forced to take the version that they beg to decline.

The children have the least say in where the research funding goes, negotiating reimbursement contracts between payors and providers, planning pharma development pipelines… My opinion is that we’re failing them.

Slam dunk against EpiPen’s de facto monopoly.

EpiPens have been generic for many years and most people don't buy the brand name EpiPen unless their insurance makes it free. Check CVS and goodrx

The ground truth I have from people in my circle is that it is still expensive and challenging to get them. Maybe that is not broadly the case, but based on that ground truth, I want cheap alternatives at scale.

Sure, making things cheaper is always better. I'm just responding to the word "monopoly" which seems to get tossed around whenever anything is expensive without any thought on why it's expensive.

The actual price of 2pk epipen is $109.99 and it lasts many years. As I mentioned in another comment, "Forty EpiPen and EpiPen Jr auto-injectors that had been expired for 1 to 50 months were tested. All 40 auto-injectors contained more than 80 percent of the labeled dose" https://www.foodallergy.org/fare-blog/expired-epinephrine-ca...

Unless some institution forces you to pay more (Eg schools and allergy shot providers checking expiry dates) the actual cost is ~$25/year if you don't have decent insurance and ~$0 if you do

Sure, making things cheaper is always better. I'm just responding to the word "monopoly" which seems to get tossed around whenever anything is expensive without any thought on why it's expensive.

Paying hundreds of millions of dollars to settle antitrust claims sounds like a monopoly to me.

https://www.biopharmadive.com/news/how-mylan-ended-up-with-a...

https://kffhealthnews.org/news/behind-the-epipen-monopoly-lo...

https://www.courthousenews.com/10th-circuit-asked-to-revive-...

https://www.reuters.com/legal/litigation/pfizer-pay-50-mln-s...

https://www.nbcnews.com/business/business-news/epipen-maker-...

Why are you linking 2016 articles in 2024? Back then the generic wasn't widely available

Because options prevent further monopoly activity that was proven to have happened (citations provided). You seem to have some interest in avoiding the truth and facts around this topic, which is odd. First “there was no monopoly,” and then “well, it was a while ago so it doesn’t matter now.” It happened, and it could happen again. Also, it isn’t enough to be generic based on manufacturing complexity and capacity, which can create a monopoly situation for a generic.

First “there was no monopoly,”

Nope, first "there is no monopoly". I don't give a shit about 2016

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