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Rural Va. EMS agency to forgo carrying EpiPens over ‘tremendous cost increase’

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AMELIA COUNTY, Va. – A rural EMS agency will forgo carrying EpiPens on board due to skyrocketing costs of the live-saving drug. If a patient is going into severe anaphylaxis, then only thing that will save them is epinephrine.

“We are no longer able to carry EpiPens on any of our ambulances or quick response vehicles,” said Jay Rupkey, with the Amelia County EMS. “This is due to the exorbitant costs involved. As of today it cost $1,200 to carry the recommended dosage on each vehicle, that is two doses.”

A recent Wall Street analysis found that the markup on the drug is 400%, which has created an outcry from those in need of it, typically patients with severe allergy to nuts.

Every ambulance in the Greater Richmond area carries a sealed drug box containing epinephrine, but not an EpiPen, that all Advanced Life Support (ALS) personnel have free access to use.

All Basic Life Support (BLS) units are only allowed to give three drugs: oxygen, the patient's own nitroglycerin or assist with the patient's own EpiPen -- or they may use an EpiPen that is on the ambulance.

BLS providers are not allowed to open the drug box, only ALS personnel are allowed access to the drug box.

“This is especially concerning for rural EMS,” Rupkey said. “Rural EMS does not have access to as many ALS personnel as suburban or urban EMS organizations.”

“If the patient is in severe anaphylaxis, the only thing that is going to help them is epinephrine,” he added.

Amelia County has four ambulances and one quick response vehicle. The total cost last year to stock every unit with the required dosage was about $3800, according to Rupkey.

“The total cost this year will be about $6000,” Rupkey said.

“The cost will increase if we use an EpiPen because we do not charge the patient for the cost of the medication,” he said. “There is serious talk now about not carrying EpiPens because it is not required by the state for us to carry this medication.”

“As a rural EMS agency we just can't afford it anymore,” Rupkey added.

Teva Pharmaceuticals developing a generic treatment, which CBS news reports could arrive by 2017.