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PEpi - The People's Epi

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Epinephrine ("epi", adrenaline) is the quintessential life-saving medication that most represents the power and promise of modern medicine.  Is has been co-opted by greedy Wall Street companies, putting millions of lives at risk through extortionist pricing.

We are are not just boiling mad at the injustice and dysfunction of the situation.  We are doing something about it.  We are taking control of the epinephrine market -- all of us.  We are Americans.  We believe in freedom from tyranny.  We help each other.  We create solutions.

​Together we win.  Join us.  Save a life.  Save a lot of lives.

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EpiPen 2-Pak

EpiPen

The current treatment is also the current problem due to costs.  There are similar alternatives.
SEE BELOW
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Other Short-Term Options

We explore and explain options that may be available today.
SEE BELOW
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Long-Term Options

The best long-term options are ones that we come up with and control as consumers.  We are so done with Wall Street holding our health hostage.
SEE BELOW

Take Action -- Be Part of Saving Lives


Epi Option
Availability
Cost
Value
Deaths to Cost
Effectiveness
EpiPen Auto-Injector
Everywhere
Outrageous
Terrible
Counting
Best
Generic Auto-Injector
Limited
Problematic
Mediocre
Some
Best
Inhaled
None - (Future?)
NA
NA
NA
Poor
Under-The-Tongue
None - (Yet)
NA
NA
None Expected*
Good?
Compounded Epi
Scarce
Reasonable?
Good?
None Expected
Best
Nasal
None - (Yet)
NA
NA
None Expected*
Good?

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EPI OPTIONS


EPIPEN AUTO-INJECTOR

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Pros     Readily available, what people are familiar with, relatively easy to use
Cons     Outrageously expensive for a lifesaving medicine, bulky, expires after only one year, have to stab yourself
Price     GoodRx.com: $600-700 for 2-pak with coupon - more without (9-5-16)
Options     Maybe congress will get them to lower the price(?!), coupons?, generic coming ($300?), don't put up with it
Comments/Future
1. Be part of changing things.
2. Expired is better than none.  The picture above is my own EpiPen's given to me by a physician family member who used similar expired EpiPens for his own children who have severe allergies.  No one can officially recommend using expired medications.  However, the reality of the chemistry is that most medicines are still 90% present and effective well beyond their expiration date.  Docs know this and this is why they often have expired medicines around for the use of their families or themselves.
3. Part of what we need to create are systems for being able to tell when a medicine is "actually" expired in reality, vs a date on a bottle.  This will put the control in the hands of the patients and users.  This will only happen if we build it.  It would greatly cut into the profits of the pharmaceutical industry, so don't think it will happen without patient direction in healthcare.  Epinephrine (clear) starts to become colored as it breaks down -- this is not rocket science.


ADRENACLICK ​(AND GENERIC)
​AUTO-INJECTOR

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Pros     Available through regular pharmacies, less expensive alternative to EpiPen, generic version available
Cons     Expensive, bulky, people aren't as familiar with it, may need to learn to use, expires like EpiPen

Price     Goodrx.com: $300-400 with coupon, a couple chains $144-200 (generic?) with coupon for 2-pak (9-5-16)
Options     $150 ballpark is getting warmer to reasonable, not there yet for something so important
Comments/Future
As above for EpiPen.  Coupon games are so annoying.  We need to work together to get to a simple working system for medicines for all of us -- especially such important ones as epinephrine.
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COMPOUNDED EPI PRODUCTS

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Pros     Total flexibility in making what a patient needs in any form, maybe even better than commercial
Cons     Relatively unknown, pharma has really put them in a box politically, banned from similar to commercial
Price     ?? Less than $100??
Options     We are working on this, this is especially where we need your help to dedicate the time and resources
Comments/Future
Compounding pharmacies can custom make a huge variety of medication preparations, including injectables and IV medicines.  There is tremendous potential to come up with reasonably priced epi form alternatives by working with compounding pharmacies.  It will take some work however.  We need quick fixes which may not be terribly polished.  Then we need to work with them to come up with more polished variations.  Yes, we will want commercially produced options down the road.  And we have some great ideas for making even better epi preparations than are currently on the market.


SUBLINGUAL EPI

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Credit: Andreas Schoeps, www.adreasschoeps.de

Pros     NO NEEDLES INVOLVED!, small convenient form factor, affordable (if patient driven)
Cons     Not on the market yet, if big pharma gets ahold of it it will still be crazy expensive
Price     Should definitely be <$100 for multiple doses, but this is an issue of a functional marketplace not cost
Options     None at the moment to purchase, participate in organizing to get it to patients affordably
Comments/Future
Early research seemed to indicate this wasn't feasible.  Later research has shown that if you use the right form factor and a much larger dose, you can get the same blood levels of epi just as quickly as with the injectable epi -- very promising and very exciting!  Patents have already been filed.  Help us work with patent holders and others to get this to the market in a conscientious way.  And you may be able to participate in the needed research to facilitate it.  And we have some great ideas for how to make the sublingual form extra easy to use and super long-lasting that we would love to see implemented in the process.  If "we" are involved in developing and bringing this to market, "we" can see that all the great ideas "we" all have can be factored in to the process.  What awesome products "we" could create!


INHALED EPI

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Pros     Even better and faster than injectable (if workable), no needles involved, smaller form factor(?)
Cons     Research thus far seems to indicate it is not feasible
Price     Should definitely be <$100 for multiple doses, but this is an issue of a functional marketplace not cost
Options     None at the moment
Comments/Future
Getting medicine into the lungs gets it into the blood stream even faster than IV.  Unfortunately, research thus far indicates that you can't get enough epi in fast enough with the methods they tested.  We still hold out hope that some forms and systems will work -- because other medicines have been made to work this way when the mechanics of things get figured out well enough.  Though even if they do, it may not be the ideal method of administering epi.  If one is having a severe allergic reaction to the point of having a hard time breathing, how are you going to breath medicine deep into your lungs?  Talk about the ultimate frustration!


NASAL EPI

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Pros     NO NEEDLES INVOLVED!, small form factor, good hope of working well, convenient
Cons     Not on the market yet
Price     Should definitely be <$100 for multiple doses, but this is an issue of a functional marketplace not cost
Options     None at the moment to purchase, participate in organizing to get it to patients affordably
Comments/Future
This may sound odd at first, but it really could make a lot of sense.  What is the classic way to use cocaine?  Why?  People snort cocaine because the lining of the nose absorbs many medicines really well and really fast.  Some migraine headache medicines, among others, are sprayed into the nose.  Many people's allergic reactions involve swelling of the face and head.  There may be additional benefit in getting epi into the body near this most significant swelling.  Epi in tiny doses has been used for years as a nasal decongestant, but relatively large doses are needed for allergic reactions.  At least one lab has “demonstrated that this needle-free nasal epinephrine formulation succeeded in achieving rapid absorption in peripheral blood comparable to EpiPen™, the leading injectable product.”  Remaining issues are putting it into a form and system that can be reliable in getting the medicine where it needs to go.  And patients with a lot of mucous and nasal congestion probably shouldn't use this form.  For many, it could be ideal.  But, again, healthcare really needs patients to start taking control.  And that is what we are doing with dok.us.

Take Action -- Be Part of Saving Lives

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