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Understanding Pharmacy Benefit Managers and the Costs of Epinephrine

Four Epi Injectors From Various Manufacturers

EAIs vs. PBMs

If you are wondering why the cost of epinephrine and other drugs has been increasing lately, read about the role Pharmacy Benefit Managers (PBMs) play. While they are supposed to be acting as intermediaries between pharmacists and insurance companies, the way they are compensated can end up costing the consumer a lot more money. This article addresses gag clauses where the pharmacist is not allowed to suggest lower cost alternatives, rebates that give PBMs 40 to 50 percent of a medicine’s list price and spread pricing where the PBM charges an employer a higher price for a drug. Please read this important article here on how you can avoid gag clauses and save money when you go to fill your next prescription.

Understanding Pharmacy Benefit Managers and the Costs of Epinephrine

By Jon Terry
July 15th, 2018

Why has the excessive cost of epinephrine auto-injector (EAIs) devices become such a prominent public health issue? Along with the drug manufacturers and insurance companies, the news media has recently called attention to the role played by pharmacy benefit managers (PBMs) for increasing our medication expenses. According to the Council of Economic Advisors, “Pricing in the pharmaceutical drug market suffers from high market concentration in the pharmaceutical distribution system and a lack of transparency.” To help better understand this relationship, the Allergy Advocacy Association is sharing an overview of selected available information and opinions on this very complex subject.

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Future of New York State Generic Epi Bill Uncertain

Future of New York State Generic Epi Bill Uncertain

Sometimes it takes a while for a few of our New York State legislators to “get it” when it comes to voting for issues related to allergies and how to better protect the public. But we do have many strong supporters who never give up trying. Senator Kemp Hannon and Assemblyman Tom Abinanti proposed a bill that would authorize a pharmacist to substitute an alternate epinephrine auto-injector (EAI) device containing the same active ingredients, under certain conditions. The bill got stuck in the assembly higher education committee, saying it was "held for consideration.” Don’t worry, we never give up either, and it would be wonderful if you could contact your legislator to voice your support.

Left to R: Jon Terry, Jennifer Jobrack, Senator Kemp Hannon, Kirsi Jarvinen-Seppo MD, AM Tom Abinanti.
L-R: Jon Terry, Jennifer Jobrack, Senator Kemp Hannon, Kirsi Jarvinen-Seppo MD, AM Tom Abinanti.

Progress of Hannon-Abinanti bill has been stopped for now

By Jon Terry
June 15th, 2018

Greetings. Since our Food Allergy Awareness Day ended on May 16th, important developments have taken place in Albany. The Allergy Advocacy Association's campaign to obtain passage for a new generic epinephrine law has reached a disappointing but not surprising conclusion for this year.

Concerning New York State bill A7219/S289 sponsored by Senator Kemp Hannon and Assembly Member Tom Abinanti, their legislation has been effectively halted. NYS Assembly Member Deborah Glick, chairman of the assembly higher education committee where A7219 was being reviewed, has "held the bill for consideration." One reason for the hold may be opposition against the bill from certain companies in the pharmaceutical industry.

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Announcing Epi Near You New York

Help us spread the word about our Epi Near You New York program. Recently approved by New York State, we will provide training to any restaurant, summer camp or daycare center on when and how to administer epinephrine. Plus, we will give them a non-patient-specific (NPS) prescription, which can be filled at any pharmacy in New York. And for 501(c)(3) organizations, the Allergy Advocacy Association will provide a payment voucher for an epinephrine auto injector, at no cost to the owner. Help us help you save lives!

 

Allergy Advocacy Association Logo

By Staff
May 14, 2018

The Allergy Advocacy Association is very pleased to introduce Epi Near You New York, an educational program to help Monroe County’s small businesses keep their customers safe. This program will enable businesses to stock and administer epinephrine to those who are not carrying their Epinephrine Auto-Injector (EAI) device or weren’t aware of their allergy, leaving them at risk for an attack of anaphylaxis.

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A Warning Bell will Ring in my Head!

"A Warning Bell will Ring in my Head!"

Trevor Leinenbach is doing an excellent job in managing his allergy to milk and can serve as a great example to teens everywhere. Thanks to the efforts of his mother Joy, they helped to start the support group, Food Allergies Coping Teaching and Supporting (FACTS) in Fairport, NY. Read here about the strategies Trevor uses to avoid anaphylaxis attacks, and the great support he receives from his college as well as friends and family.

Trevor Leinenbach discusses living with food allergies and asthma

Joy and Trevor Leinenbach; March, 2018
Joy and Trevor Leinenbach; March, 2018.

By Jon Terry
April 12th, 2018

Trevor Leinenbach has lived his entire life with life-threatening food allergies and asthma. He and his family, particularly his mother Joy, have spent many years educating themselves and others about the dangers of anaphylaxis. He recognizes the importance of being a role model for other young men facing many of the same issues he deals with day after day. Now attending Clarkson University in the northern most area of New York State, Trevor recently shared a few of his life experiences at an allergy support group. This support group, Food Allergies Coping Teaching and Supporting (FACTS), has bi-monthly meetings in Fairport, NY. Partly initiated by Joy, FACTS has helped many parents and kids at risk for anaphylaxis. Here are a few excerpts from my meeting notes. 

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Should Pharmacists in NYS write Rx for Epinephrine?

Many of the initiatives your Allergy Advocacy Association was successful in implementing were from legislation that had been passed in other states. Our next goal is an idea from the state of Idaho where pharmacists are now allowed to write prescriptions for epinephrine, thanks to the efforts of a pharmacist whose son has food allergies. You can read the full article here.

Should Pharmacists in NYS write Rx for Epinephrine?

>Starla and Mitchell Higdon at the Idaho state capitol
Starla and Mitchell Higdon at the Idaho state capitol.

By Jon Terry
March 12, 2018

After founding the Allergy Advocacy Association eight years ago, I knew I would have to imitate the already existing ideas and creations from other people’s work. Why did I decide to do this? Because I was determined to do whatever it takes to raise awareness of the dangers of anaphylaxis. To become an effective public advocate, I would have to learn about new things but also copy many things that already existed. There was no good reason for our association to re-invent the wheel, so to speak. And when it came to advocate for new legislation in my home state of New York, I searched for successful laws already enacted in other states. If it “plays in Peoria,” why not try it in Albany as well? Sure, some folks might accuse me of stealing promising ideas from others. But I prefer to think of the process not as larceny, but as flattery instead.

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