OBJECTIVES: To assess epinephrine auto-injector (EAI) availability and use for anaphylactic events in US schools during the 2013-2014 school year.
METHODS: This exploratory, cross-sectional, web-based survey analyzed anaphylactic events in eligible schools participating in the Mylan-sponsored EpiPen4Schools® program, an ongoing initiative providing free EAIs and training to schools nationwide.
RESULTS: Survey participants consisted of 6019 of the >40,000 schools in the EpiPen4Schools program. A total of 919 anaphylactic events were reported in 11% of schools (607/5683). Importantly, 22% of anaphylactic events (n=187) occurred in individuals with no known allergies; most events (89%, 757/852) occurred in students. Of the 851 events with treatment information, 75% of individuals (n=636) were administered epinephrine via an EAI, 49% (n=310) of whom used the schools’ stock EAI provided through the EpiPen4Schools program (despite known prior allergies in 69% of anaphylactic cases). Of note was the disparity between the number of qualifying schools in the EpiPen4Schools program, nationwide, with Illinois having the highest (n=2282) and District of Columbia the lowest (n=4) number of participating schools.
CONCLUSIONS: One in 10 schools participating in the survey reported ≥1 anaphylactic event during the 2013-2014 school year. Of those individuals treated with EAIs, nearly half used their school’s stock EAI, provided through the EpiPen4Schools program, suggesting the value of stocking EAIs for student/staff safety and potential cost savings. Studies on the cost of inpatient care for anaphylaxis indicate approximately $4700 per event. Furthermore, data suggest significantly higher treatment costs and poorer outcomes when treatment with an EAI is delayed. The prevalence of anaphylaxis continues to increase, as do the costs associated with receiving treatment and delaying or failing to receive treatment; removing barriers to access and increasing availability of treatment is an important public health goal.
