Study on Anaphylaxis Incidence Shows Low Epinephrine Auto-Injector Prescribing Rates

The final analysis included 52,045 patients in a large health maintenance organization
The final analysis included 52,045 patients in a large health maintenance organization

Findings from a study published in the Annals of Allergy, Asthma & Immunology suggest the ongoing difficulty in diagnosing anaphylaxis as evident by the low prescribing rates of epinephrine auto-injector in cases of anaphylaxis.

Estimates on the incidence of anaphylaxis are insufficient and the current International Classification of Diseases, Ninth Revision (ICD-9) codes present a challenge in accurately diagnosing anaphylaxis and assessing epinephrine prescribing. Study authors aimed to calculate the incidence and and demographics of patients with anaphylaxis-related ICD-9 codes in a large health maintenance organization and to analyze rates of epinephrine prescribing and dispensing. 

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Eligible patients had at least 12 months of continuous membership from January 1, 2008 to December 31, 2012 and were chosen based on anaphylaxis-related ICD-9 codes (n=159,172). The final analysis included 52,045 patients after excluding individual chart reviews with expanded ICD-9 codes representing unconfirmed anaphylaxis cases. 

The data showed that the incidence of anaphylaxis over the 4-year period was 2.07% with a higher prevalence in females vs. males (56.5% vs. 43.5%). Of the total cases, epinephrine was prescribed in 16.2%. The highest rates of epinephrine prescription were for the ICD-9 codes 995.0 (other anaphylactic shock) and 995.60 to 995.69 (anaphylactic shock caused by food) at 49.3% and 58.6%, respectively. Epinephrine auto-injectors were dispensed 95.9% of the time when prescribed regardless of the copay amount. 

Study authors concluded that the continued difficulty in diagnosing anaphylaxis "could result in suboptimal treatment of potential future episodes." 

For more information visit annallergy.org.

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