Allow greater access to epinephrine. It can save lives.
$27,000. Or €21,000, that’s what the pain and suffering of losing a daughter is worth, at least according to a court in Dublin. Emma Sloan’s family settled with a pharmacist who refused to give her epinephrine because she didn’t have a prescription on her.
Emma, 14, was anaphylactic from accidentally eating a sauce that contained peanuts. She later died with her mother trying to get to a hospital. As the father of a child with food allergies to peanuts, tree nuts, egg, and sesame, my worst nightmare is to be caught without epinephrine while my child fights to breathe. My baby went to the hospital for a severe reaction to sesame in 2019. Luckily, we had epinephrine on hand to save her life.
Not only do I understand some of the fear Emma’s mother experienced, I know exactly how this could have happened to my child, or anyone’s child. Earlier this year, I remembered to check the expiration date on my child’s epinephrine. I dug the autoinjector out of my bag and looked. The date had long since passed. I was walking around with weakened, if not useless epinephrine for months. You always carry two doses of epinephrine because one might not be enough. What if the worst happened and two doses did nothing or almost nothing while we waited for an ambulance? I felt ashamed as a parent. How could I make this mistake?
We requested a refill from the pharmacy. The pharmacy said we had no refills, and they would talk to her doctor. We heard nothing. We reached out, finally the prescription was sent and filled. All in all, my child had no epinephrine for two weeks. What if during that time someone made a mistake, and my daughter ate the wrong thing? No parent is perfect. We never will be. Our healthcare system should be set up to meet people where they are, imperfections and all. Once I realized my mistake, why did my child even go two weeks without life-saving medication?
Right now, a law is waiting to pass in North Carolina that could have changed that. If it had been law where Emma Sloan was, she would be alive today. House bill 512, Pharmacists Improve Public Health Needs, would allow immunizing pharmacists to prescribe certain medications, including epinephrine. Idaho already has a similar law. If House Bill 512 was law, the day I realized my child’s epinephrine expired, I could have fixed it. I am a nurse. My child has everything she needs, and I know how to navigate the medical system, and yet even she had a gap in life-saving medication. There are thousands of families across North Carolina who are just trying to survive every day and take care of their own or a child’s food allergies. This law needs to pass in North Carolina as soon as possible.
Except there is a twist. The North Carolina Medical Society opposes this bill, a petty turf battle with my daughter and many other people who need public health medications caught in the middle. Doctors wants to keep the power of prescribing medications to as few providers as possible because that upholds their power. Pharmacists are completely capable of prescribing public health medications outlined in the bill, which would enhance patient safety by helping folks have all the medications they need. Pharmacists have this prescribing authority in other states.
A version of the bill managed to pass the state Senate, but epinephrine was removed from the list of medications pharmacists would be allowed to prescribe. This is unacceptable. When I read Emma’s story, I knew that it could happen in North Carolina. Legislators, don’t let petty bureaucracy blind healthcare providers to what they need to do to save a life. Pass a bill that includes epinephrine prescribing for pharmacists.
This story was originally published May 30, 2021 at 12:00 AM with the headline "Allow greater access to epinephrine. It can save lives.."