August 27, 2018

Statement about shortage of epinephrine auto-injectors

From Amy Gutierrez, Senior Vice President and Chief Pharmacy Officer, Kaiser Permanente

The serious shortage of epinephrine auto-injector pens is affecting national and even global supplies of these devices. As a result, some community pharmacies have even run out of their supplies of this critical medication. The Food and Drug Administration has recently taken extraordinary actions, including authorizing use of injectors past their expiration date, and allowing for products with particulate matter to remain in the U.S. supply chain. These are uncommon actions by the FDA, all in an effort to ensure adequate supply.

At Kaiser Permanente, we are working to ensure supplies are available for the 94,000 patients among our 12 million members who need these devices. Through careful stewardship we are continuing to dispense auto-injector prescriptions for our patients, even as supplies dwindle or run out in some communities. Kaiser Permanente will continue to work on securing additional supplies as they become available.

Until supplies return to adequate levels, our pharmacies are dispensing one auto-injector pen at a time per patient. This practice is endorsed by our physician and pharmacist experts to preserve access to this lifesaving medication for all of our patients during this shortage. As is always the case, treatment plans for a specific clinical situation are developed by each patient’s physician and communicated to our pharmacies.

Over the last couple of years, we have all become accustomed to receiving the product as a two-pen set, and so we know it can create anxiety to receive only one new pen at a time. However, we are trying to avoid the far worse case: a patient getting no pen, because supplies are exhausted. In the midst of this serious shortage, we are doing our best to ensure everyone has access in an emergency. As supplies start to return to adequate levels, we will remove the one-pen limit.

We acknowledge our members’ concerns over having a co-pay each time a single pen is dispensed, and we regret any inconvenience or frustration this has caused. We previously indicated we were working to address this, and this week we have changed our collection of co-pays for epinephrine auto-injectors. Effective immediately, we will collect a co-pay only when the second of the two pens from a prescription is dispensed; members will not be charged a co-pay when they receive the initial, single pen. We are also in the process of communicating a way for members who have already paid two co-pays for one prescription to obtain a refund.