Can I buy an epipen? 2nd Epipen refusal by GP

[jwpetal]

I was hoping for some help. My son has food allergies, peanut/nut allergy, hay fever and asthma. He has had epipen since he was 3 now 8. Though he has not been given the epipen before, he has had a major incident that required oxygen and additional antihistamines, while under hospital care. We know he is classed as high risk.

Our GP practice has refused to provide a second epipen for home and school. The GP was horrendous. Stating that it is not financially worth it and if it were so important the school or the hospital would pay for it. There was no clinical review of his file. Our allergist consultant has sent a letter to the practice (they sent on 12 February and still not on our son's file at the practice). I tried to hand deliver and they would not take it. I am filing a complaint against the GP, but that does not solve my problem.

the consultant is trying to contact our GP. The school is trying to get the school nurse involved.

If we cannot get the 2nd epipens, can we buy them? We do a fair bit of travel and these are the times we are more likely to have any problems. Anyone have this happen? do I have any recourse?

Can the consultant not issue a prescription?

£45 on Lloyd pharmacy but you need a script onlinedoctor.lloydspharmacy.com/uk/allergy/epipen

My understanding was that if a child needs an epipen then they should be given one for home, one for each childcare setting and possibly one to travel with. That's the case with the child with allergies I care for.

Complain to the practice, primary care group PALS and anyone else you can think of. It is absolutely in compliance with current advice to have 2 epi pens in any location needed incase one doesn't work or a second dose is needed.

We have ended up with four extra due to a prescription error - happy to post you one if you pm me

i had the same, but the GP grudgingly accepted and prescribed a second one after the consultant sent a letter.

Another option is to "lose" your first one and ask for another prescription.

You need to change your GP, also explain the situation to your consultant - he may be able to prescribe you them.

You should have two epipens and pirton (or equivalent) in each emergency pack. Along with his care plan from your consultant. So, you need at least 4. The second epipen is in case the first doesn't work or a second dose is required.

Our GP has no issue with prescribing epipens for reasonable requests, he got a bit peeved when I asked for prescription piriton, i normally buy it OTC but the school insists that all medication they give have to have prescription labels on them (which I can understand).

Placards and a sit in protest in the surgery on Monday morning. Call the newspapers and the radio and shame them into providing one. Then change GPs quick smart!

ilove thank you for the offer. I will give it to Monday and if no response, I will take you up on it. I have realized that I may have to change GPs or they may kick me out as I have written quite a document of complaint including documentation from NICE and MHRA and Anaphylaxis.org. What makes it worse as he is a partner in the practice. Just waiting to see if the consultant turns things around and then act. I think I am in the middle of some budgetary fight.

We haven't had problem with the antihistamine and we go through a lot as well as other medications during various allergy seasons. I thought about losing the first epipen but then thought that is not a long term solution.

I'll let you know how it all resolves.

jwpetal, it might not help (but it might); our GP refused to prescribe a 2nd one, but i fought it out and discovered their concern was that they expired very quickly. I pointed out my last one had lasted 11 months, and thus they were only prescribing slightly over 2 a year and that it wasn't safe if i left it at nursery by accident (or vice versa). They agreed in the end (though DS was only 2, and we buy all our other meds over the counter). they had originally thought they would be prescribing 2 every 2 months or so...

we've always had 4 epi-pen on the go at a time. 2 based at school and 2 at home. don't the anaphylaxis guidelines state that one must be injected then the second one if needed?

Your consultant must be able to prescribe more or give the gp a stern talking to.

We have 2, one at home, one at school, and she used to have one at guides, although the GP was reluctant to allow 3.

I carry 2 Jext pens- have a longer shelf life than pipes, so are cost effective. You need a second one in case the first does not work. I would complain to the GP practice. You can also raise it with your local Healthwatch; look up a patients advocacy group if you want some help behind you when you complain, or write to your MP. Ask about Jext, though as it has a longer shelf life.

I don't understand the need to have 2.
My son has had one since he was 4. And it has never been used, he carries it everywhere, and therefore there is no need to have one in every childcare location. In fact, having it under lock and key in an office somewhere is distinctly unhelpful.

We very very quickly got used to carrying it everywhere, a bit like my phone and my handbag.
And I have stuffed up a couple of times, once travelling to Birmingham without it- 500 miles, and I needed to organise a new script and pay for it, and once he went to scout camp without it. Fortunately, one of the parent helpers had one for her son, and said that DS could use it if necessary, and at that point I would have gone out with his, and collected him.

To be honest, and I say this as a parent of a child with allergies, your doctor is right. They cost a lot, they have a short life span, and we have an NHS which does not have money to throw about. I suspect of we were having to pay for the cost of epicene, people would suddenly only need one at a time.

But most schools wouldn't let a child carry an epipen-they would need to be kept in medical room

Bafana The MHRA advises that all patients should carry two at all times. It's not really about 'forgetting' or losing them or even the cost.

Thanks for the link.
That is interesting reading, and I will certainly see my gp about it.
However, in my experience, most people who have two, don't carry both together, so are not following these guidelines either.

I hope that you get it sorted OP. I do remember how stressful it was when DS initially got his epipen, and in some ways it was a relief as I had known he was allergic for several years, but they wouldn't prescribe an epipen until he had a major episode.
Fortunately, he is now 13, and has only had one further occurrence, and that's when my tosser of an ex gave him cake, from which he scrapped off the peanuts!!!

DS has carried his epipen since p3, we are in scotland. After speaking to school, it was decided that it was better for him to carry it than it be locked in a cupboard, and signing it in and out everyday would be ridiculously time consuming.

Please be careful if getting one from someone else, kind as the offer is the dosage is different for adults and children below 30kg -epipen vs epipen jr. Not sure if this applies to your DS or not, OP just be careful it's the right dosage if you do take a spare from someone else

I was only given 2 for my DS, I paid for an additional 2 by obtaining a private prescription from my GP, this way i could leave 2 at his nursery. now he is at school it seems to be easier to have 4, so we now have 4. I have used the epipen on him, having a second pen available was essential as we had no idea if /when he would start reacting again.

The reason that two epipens are prescribed is because you may need the second dose if an ambulance takes a while to reach you. In London (or rural areas) the response time can be as much as 40 mins by which time a second dose is necessary for a severe reaction.
DSS has a peanut allergy and has always been prescribed two. His school hold some centrally but two are always required for school trips.
He used to attend an after school club and I managed to wangle an extra one then but two seems fine now.

your GP is being a tw*t and just citing "school needs two for trips" should be enough to get another.

Just an update. The hospital has prescribed two more for ds and then had a long conversation with the GP, who is talking to the practice partners to decide if he should have it in the future. I think this is over the top and ignoring is medical history (previous anaphylaxis reaction - only saved because son was in hospital at the time).

My son is now 8 and has been carrying his medication since he was 2. He reads his own labels on food to see if okay to eat and is learn to cook and about food precautions. I use our practice epipens and teach parents that have him over how to use them. His sisters have also been taught about it and watch over him.

I contacted our CCG (PCT), who said that the ability to prescribe epipens is with the GP and they have not sent guidelines to the GP that they cannot do so. Essentially, the GP is misinformed about policy or lied. Either way not very comforting.

A complaint letter has been sent as either way the practice is rubbish.

I have a serious allergy, my GP always prescribes two epipens at a time. I normally only need one but there are no guarantees. I'd be seriously considering changing GPs

I am glad you are taking this further.

I agree with RocknRollNerd upthread: your DS should have 2 at home and 2 at school as per guidelines. Yes, hopefully he will never need them and they do go out of date, but they should be in place.
There is an alternative manufacturer of pre filled adrenaline pens which is much less expensive than branded Epipen Jext which is preferred in some health boards, so don't be put off if another name is prescribed - the active ingredient is the same.
The other issue is that pharmacies sometimes issue the pen with the shortest expiry date to get rid of stock - this often leads to new pens being required quickly even though they were not used.