F Estelle R Simons1. 1. Department of Pediatrics and Child Health, Canadian Institutes of Health Research National Training Program in Allergy and Asthma, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba. lmcniven@hsc.mb.ca
Abstract
BACKGROUND: Epinephrine (adrenaline) is an essential medication for the treatment of anaphylaxis. Epinephrine auto-injectors are universally recommended as first-aid treatment for anaphylaxis occurring in community settings. In a World Allergy Organization survey conducted in 2003, auto-injectors containing 0.3 mg of epinephrine were reported to be available in 56.4% of countries and those containing 0.15 mg of epinephrine were reported to be available in 43.6% of countries. Auto-injectors containing an infant dose were not available in any country. The cost of 1 auto-injector ranged from US $30 to US $110. OBJECTIVE: To ascertain if availability and affordability of epinephrine auto-injectors had improved worldwide between 2003 and 2007. METHODS: The survey instrument designed for use in 2003, with 2 additional questions, was self-administered by allergy/ immunology specialists in the 2007 World Allergy Organization House of Delegates. Responses were tabulated by country. RESULTS: Completed surveys were received from 1 or more representatives of all 44 countries with voting delegates (100% response rate). At the time of the survey, auto-injectors containing 0.3 mg of epinephrine and auto-injectors containing 0.15 mg of epinephrine, were available through official distribution channels in 26 (59.1%) of 44 countries (95% confidence interval for percentage of countries, 43.2%-73.7%). Auto-injectors containing an infant dose were still not available in any country. The unsubsidized median cost of 1 auto-injector was US $97.87 (range, US $54.50-US $168.66). CONCLUSIONS: Since 2003, the global availability of auto-injectors containing 0.3 mg of epinephrine has improved slightly. The availability of those containing 0.15 mg of epinephrine has improved more. Auto-injector costs have increased. The lack of availability and affordability of epinephrine auto-injectors for the first-aid treatment of anaphylaxis in the community remains a concern in many countries.
BACKGROUND:Epinephrine (adrenaline) is an essential medication for the treatment of anaphylaxis. Epinephrine auto-injectors are universally recommended as first-aid treatment for anaphylaxis occurring in community settings. In a World Allergy Organization survey conducted in 2003, auto-injectors containing 0.3 mg of epinephrine were reported to be available in 56.4% of countries and those containing 0.15 mg of epinephrine were reported to be available in 43.6% of countries. Auto-injectors containing an infant dose were not available in any country. The cost of 1 auto-injector ranged from US $30 to US $110. OBJECTIVE: To ascertain if availability and affordability of epinephrine auto-injectors had improved worldwide between 2003 and 2007. METHODS: The survey instrument designed for use in 2003, with 2 additional questions, was self-administered by allergy/ immunology specialists in the 2007 World Allergy Organization House of Delegates. Responses were tabulated by country. RESULTS: Completed surveys were received from 1 or more representatives of all 44 countries with voting delegates (100% response rate). At the time of the survey, auto-injectors containing 0.3 mg of epinephrine and auto-injectors containing 0.15 mg of epinephrine, were available through official distribution channels in 26 (59.1%) of 44 countries (95% confidence interval for percentage of countries, 43.2%-73.7%). Auto-injectors containing an infant dose were still not available in any country. The unsubsidized median cost of 1 auto-injector was US $97.87 (range, US $54.50-US $168.66). CONCLUSIONS: Since 2003, the global availability of auto-injectors containing 0.3 mg of epinephrine has improved slightly. The availability of those containing 0.15 mg of epinephrine has improved more. Auto-injector costs have increased. The lack of availability and affordability of epinephrine auto-injectors for the first-aid treatment of anaphylaxis in the community remains a concern in many countries.
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Authors: F Estelle R Simons; Ledit R F Ardusso; M Beatrice Bilò; Yehia M El-Gamal; Dennis K Ledford; Johannes Ring; Mario Sanchez-Borges; Gian Enrico Senna; Aziz Sheikh; Bernard Y Thong Journal: World Allergy Organ J Date: 2011-02-23 Impact factor: 4.084
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Authors: F Estelle R Simons; Ledit Rf Ardusso; M Beatrice Bilò; Victoria Cardona; Motohiro Ebisawa; Yehia M El-Gamal; Phil Lieberman; Richard F Lockey; Antonella Muraro; Graham Roberts; Mario Sanchez-Borges; Aziz Sheikh; Lynette P Shek; Dana V Wallace; Margitta Worm Journal: World Allergy Organ J Date: 2014-05-30 Impact factor: 4.084