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Lawmaker Says Maryland Schools Should be Able to Afford Epinephrine

The Maryland lawmaker who introduced a bill that would require school personnel to be trained to respond to anaphylaxis says schools should be able to afford the cost of Epi-Pens, despite concerns by school districts over the costs of the medicine.

Maryland Governor Martin O’Malley signed the bill into law in May, requiring each county board of education to establish a policy to authorize school personnel to administer auto–injectable epinephrine in allergy emergencies. It also mandates school districts come up with a training program for responding to anaphylaxis. The law does not require that schools stock epinephrine or provide any kind of funding to obtain the medicine.

It wasn’t a mistake that the legislation didn’t require schools to stock Epi-Pens. A line in the bill requiring the schools to stock epinephrine was taken out because it was assumed that “if you’re going to have the policy that you’re going to have the Epis in stock,” said State Sen. Christopher Shank.

Shank,the primary sponsor of the bill[2], says schools should have no problem affording them.

“The cost is negligible,” Shank said. A Maryland-based distributor in Maryland provides discounts for schools, he added. “For a school district to say they’re not going to have lifesaving medicine is reprehensible and irresponsible.”

Shank says he introduced the bill after being provided information with the Food Allergy and Anaphylaxis Network on the prevalence of anaphylaxis in children with unknown allergies. Some districts already have Epi-Pens on hand, while others wonder how they will afford it if stocking them becomes mandatory. Some even opposed the bill, Shank said.

“I don’t understand why they would be opposed to this. We’re talking one Epi-Pen per school. It’s not that large a cost compared to other education expenditures,” Shank said. 

The Maryland State Department of Education (MSDE) says it plans to require schools to stock epinephrine, spokesman Bill Reinhard said on Wednesday. St. Mary’s County Public Schools Superintendent Michael Martirano said the 45 doses needed to cover the district would cost around $10,000 annually. For bigger school systems like Prince Georges County Public Schools (PGCPS), the estimate is ten times that.

Inquiries to Epi-Pen producer Mylan on costs and shelf life of the medication were not immediately returned.

“Purchasing a stock of auto-injectable Epinephrine inventory is cost prohibitive,” said Karyn Lynch, PGCPS Chief of Student Services. “Also, administratively maintaining a current supply presents numerous administrative challenges.”

Reinhard said one of those challenges has been working with health officials to figure out how schools can get the medicine without having an individual prescription for every kit, for example. Kits must be replaced every year.

Shank is confident the costs of the medicine will pay off in lives saved.

“Not many decisions we make in Annapolis make a difference between life and death, [but] this is one of those things. There was a7-year-old girl who died in Virginia[4]. I don’t want to have that in Maryland.”

Photo byVu What When/flickr