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    • “Diabolical” pretty well sums it up. I thought the author did a great job of explaining/demonstrating what a colossal mess we have — especially for readers who, previously, might not have fully comprehended the problem.


      • There’s competition, but apparently there have been ongoing problems with creating a simple, easy-to-use device that delivers the proper dose every time. And I wouldn’t bet my life on a device from an online company/brand not even mentioned by the National Institutes of Health as one of the brands available in the US:

        There are 3 brands of autoinjectors available in the United States, but they are not interchangeable with respect to training and the way they are used. Given that anaphylaxis may not occur very often at any one location, it can be hard to remember how to use different devices. Patients often forget how to use them within 3 months,2 and many health professionals have never been trained to use them at all.

        EpiPen is the most commonly used device, although it has occasionally been misused when people hold it upside down, press, and inject their thumb or when a child gains access to the device and presses the wrong end. Both situations have been reported to ISMP; most recently a thumb injection by a nurse was reported. Auvi-Q is another brand of autoinjector. It may be easier to use than the EpiPen, because it provides digital voice instructions and the needle retracts to lessen the risk of a needlestick injury. A generic autoinjector from Lineage Pharmaceuticals, which costs about 20% less than the other brands, is more difficult to use. The product will not be familiar to those who currently know how to use one of the other autoinjectors. Also, we recently informed Lineage Pharmaceuticals that its pen lacks a barcode, an issue that the company promised to address.


        • The National Institute of Health is part of the problem. The most expensive alternative is approved by Medicare and yet others that can be used safely and effectively with a minimal amount of training must be paid for directly. Who’s ox is getting gored here? Think about it.


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