KEY POINTS:
Pharmac is gambling with the lives of allergy sufferers by refusing to buy them automatic adrenalin injectors, says an Auckland man who nearly died from his food allergy.
Paul Martin, who buys his own single-use EpiPen auto-injectors - and has been saved by them - spoke out yesterday
after the death of Aucklander Grant Freeman.
The Herald reported yesterday that Mr Freeman, aged 38, died last Thursday after his hospital life-support was switched off. He had severe brain damage. His heart had stopped beating for several minutes two days earlier before being treated at the cafe where he had collapsed.
His sister Donna Whittle wonders if his meal was inadvertently contaminated with a trace of one of the foods he was allergic to - peanuts, tree nuts, eggs, seafood and chicken.
Mr Freeman did not realise his life was in danger. But could an EpiPen have prevented the tragedy?
EpiPens cost about $160 and have a shelf life of 18 months after manufacture. Around 6000 people in New Zealand have them.
Allergy New Zealand chief executive Penny Jorgensen said Pharmac should fund EpiPens for all of the estimated 20,000 people at risk of severe allergic reactions to foods - the majority - or insect stings.
So-called anaphylactic shock is a severe, life-threatening reaction. Symptoms can include diarrhoea, constricted breathing, and a drastic drop in blood pressure.
Pharmac's medical director, Dr Peter Moodie, said it had decided against funding EpiPens partly because of their cost, but mainly due to the difficulty of identifying those at greatest risk of anaphylaxis.
ACC buys EpiPens for some people who have had anaphylaxis after insect stings and some other allergy sufferers on low incomes have received funding for them from Work and Income.
Pharmac does pay for syringes and tiny bottles of adrenalin - kits worth less than $10 - but Allergy NZ, Auckland City Hospital immunologist Dr Penny Fitzharris and Mr Martin were scornful of this.
"We think it's an unsafe device and should never be prescribed," said Mrs Jorgensen.
Mr Martin, an Auckland accountant who is allergic to numerous foods, said Pharmac's position was ridiculous: "Why does Pharmac continue to play Russian roulette with our lives?
"I went through the allergy clinic at Auckland Hospital. They recommend the EpiPen and show you how to use it on the spot before you leave. It's so much easier to use than a syringe. There's no way my wife would use a syringe [on me] but she's happy to use an EpiPen. You slap it against your thigh hard and the needle pops out and does it.
"It takes about 10 seconds to use, but it can take a minute to load and inject the syringe-based subsidised solution. And that's when you're not already suffering the debilitating effects of early anaphylaxis. Once a serious allergic reaction starts you only have minutes to seek help."
Mr Martin has had two bouts of anaphylaxis; in one, he was just minutes from death.
Dr Fitzharris said Pharmac's clinical advisory committee recommended funding EpiPens, but ranked them as of only moderate priority - too low for it to happen.
"One of the factors that comes out in all studies of death by anaphylaxis is delayed use of adrenalin," she said.
