Anaphylaxis wallchart

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Editor, – I write in response to the anaphylaxis wallchart1 and would like to comment on the impracticality of advising Epipen as an alternative to adrenaline ampoules and syringe.

I am sure the Editorial Committee of Australian Prescriber are aware that Epipen is only subsidised when it is prescribed by clinical immunologists, paediatricians and respiratory physicians but not by other health professionals. Other doctors must purchase it privately at a cost of $104. Because it does not last long, replacing stock is costly. Even when I was a member of the Australasian Society of Clinical Immunology and Allergy, I could not prescribe Epipen on authority as I am a dermatologist. It did not matter that some of my patients with eczema had a severe peanut or latex allergy, I still was not allowed to write an authority prescription.

Perhaps if Epipen was available as a doctor's bag item under the Pharmaceutical Benefits Scheme (PBS),2 health professionals may have better access. It would make sense to have Epipen as an alternative on the wallchart, but until such time, it is too expensive to place it as a viable alternative to adrenaline ampoules for health professionals.