The Auvi-Q is out! Can it replace the Epi-Pen?

Some of you may have heard the story already.  Twin boys (now men) set out 15 years ago to develop a better way to deliver epinephrine in an emergency.  Three weeks ago, their creation – the Auvi-Q – was finally released commercially by new owner Sanofi.  The Auvi-Q was expected to be revolutionary thanks to its audio instruction capability that walk a user through each stage of the injection process.  In addition, it promised to be much smaller and capable of delivering the appropriate amount of epinephrine in 5 seconds versus the 10 seconds required by rival Epi-Pen (owned by Mylan).

The promise was great.  The build-up fantastic.  But what would it REALLY be like?  I needed to know.  I needed to share it with you.  So after calling around and finding a pharmacy 20 minutes from my home that carried the Auvi-Q upon its release, I obtained a prescription and drove to the pharmacy.  I can’t explain why I was so excited to get the Auvi-Q.  Was I feeling what Apple fans feel when a new iPad comes out?  Nah, I wasn’t that excited.  But there was a real sense of anticipation.

Unfortunately, the Auvi-Q costs $299 for two devices and a trainer.  Fortunately, on the Auvi-Q website, Sanofi advertises a special savings offer that implies a subsidy so that no one will pay over $25 for their first 2 prescriptions of the Auvi-Q.  Unfortunately, the one state that is not covered by this program is Massachusetts… where I live.  Fortunately, my insurance company does already cover the Auvi-Q.  Unfortunately, that coverage equalled $72.  (Got all those fortunately’s and unfortunately’s?)

In any case, my enthusiasm piqued the moment I opened the box, pictured here.

Note the two active devices on the left and the trainer on the right.  Behind the trainer were papers with drug information, etc.  So what did I notice next?  Check out the size!!!

Yes, that’s a standard size business card next to the Auvi-Q!  And what you’re looking at is the Auvi-Q in its protective casing!  Here’s another comparison of the Auvi-Q’s size.

Wow!  Look at the size difference versus the traditional Epi-Pen (also in its case), not to mention the smaller form factor versus a typical smartphone!  How about the thickness, you ask?

 
OK, so my photography skills leave much to be desired, however you can still get the general idea here.  The Auvi-Q is somewhat slimmer than the Epi-Pen (again, in its case) and roughly similar to my son’s cell phone.

Next, I wanted to see how how the Auvi-Q worked, so my son and I used the trainer. We found that the instructions are clear and simple, as is the administration of the device.  In terms of timing, It was about 13 seconds from the time my son reached into his pocket for the device until the injection would be complete. We also realized that you do not have to “jab” the device into your thigh.  In fact, the trainer says you should place it against your thigh and then push.  The push requires very little effort – the needle seems to be injected with a trigger mechanism of some sort.  Due to this, plus the fact that the cap is on the end where the needle comes out, AND the shape of the device, my assumption is that it is much less likely that a user would jab his or her finger by accident versus using a traditional Epi-Pen.  In addition, the odds of injecting incorrectly have to be lower as well, I would guess.  It should be much harder to miss the mark and much less likely to hit at an angle that would cause the needle to bend and not inject versus using an Epi-Pen.  Again, these are all assumptions on my part, but rational ones I believe.

We’ve now had 2 weeks now to experience the Auvi-Q.  First, we decided to see how it would fit in my son’s front pocket.  Check out the next 2 pictures.  Can you tell which is the Auvi-Q and which is the Epi-Pen?

Suffice it to say that he wouldn’t consider carrying the Epi-Pen in his front pocket, but the Auvi-Q was actually less noticeable from the outside than even his cell phone.  Now my son isn’t a “back pocket” kid, but clearly the Auvi-Q would be less conspicuous in a back pocket versus the Epi-Pen or even a cell phone, and today’s teens have no problem carrying cell phones in their back pockets.  So that’s a definite plus on the Auvi-Q.  If it can help increase compliance amongst teens, fatalities could very well decline in this riskiest of demographics!
But how did my son feel carrying it around?  The first day he kept two Auvi-Q’s on him at a Boston Bruins hockey game.  He was wearing jeans that night and kept one is each front pocket.  Since he usually keeps his phone in one pocket (which he forgot that night), he didn’t think anything of having these on him, even with jeans.  So that was a success.  The next day he brought them to school and kept one in his khakis throughout the day.  I was a little surprised when he told me the Auvi-Q felt a bit bulky… until he subsequently told me he kept it in the same pocket as his phone.  When he had it in his pants without the phone, everything was fine.

But the best story is the one I didn’t plan.  I’ve been keeping the Auvi-Q’s on my home office desk, but my son (who is 15, by the way) apparently didn’t know that.  He was going to a semi-formal function on a Saturday night and I was already out of the house.  Before he left, he grabbed his Epi-Pen’s and then decided that the Auvi-Q’s would be a much better option for the evening… but he couldn’t find them.  He was disappointed.  And here’s the key!  Because he brought the Epi-Pen’s, he kept them in the next room over from where the function was being held, whereas if he had the Auvi-Q’s he would’ve kept at least one in his pockets.  So if there had been an actual emergency, would he be able to get to the Epi-Pen on time without panicking?  Would his friends know where it was?  How about with the Auvi-Q?  Again, compliance is critical in teens!  (All this, of course, doesn’t necessarily apply to just teens though.)

Now it was time for me to go through the “daily life exercises.”  Generally, I carry 2 Epi-Pens and 4 pre-measured packets of children’s Benadryl (actually, these are no longer available under the brand name Benadryl, but CVS still carries generic pre-measured packets) in a small case that attaches to my belt buckle.  I found that the Auvi-Q truly “freed” me!  No more case hanging off my belt buckle! – and if I were a teen, that would be a BIG deal to increase compliance.  Instead, I kept one Auvi-Q in each of my back pockets.  I’ve been doing so for almost a week now – sitting, standing, moving – and I’ve found the Auvi-Q’s extremely convenient.  They easily fit in my pockets and I haven’t even noticed them unless I’ve been sitting, and even then they’re not uncomfortable.  Personally, I’ve liked traveling with Auvi-Q’s much more than carrying Epi-Pen’s and their bulky case.  However, the negative is that I have to carry the Benadryl packets separately now and I find it annoying to put those in my pockets.  Women carrying a purse and others may not experience this same frustration.

But will the smaller Auvi-Q’s get lost in a purse or backpack?  I didn’t try this one with my wife yet, but I did do a little test with my son.  As soon as he got home from school one day, I asked where his Auvi-Q’s were.  One was in his pocket, the other in his backpack.  This backpack was bulging with books and more!  So I said “Get the Auvi-Q from your backpack as quickly as possible.  Go!”  He was surprised, but managed to pull in out in 7 seconds.  Not bad.  It wasn’t so small that he had to go searching.  Now I wouldn’t exactly call this a scientific test, but consider it as you may.

That leaves one burning question in my mind – does the Auvi-Q work?  My apologies, but I hope not to find out the hard way.  Frankly, seeing that it’s been FDA approved, I have to assume that it does and I’ve had no problem taking these with me and leaving the Epi-Pen’s at home.

As an aside, I have to share a little more.  After hearing of the Auvi-Q, I came up with another one of my brilliant ideas (yes, please note the sarcasm).  I thought of patenting a process whereby the use of an epinephrine auto-injector would automatically send a signal to emergency personnel along with the location of administration (using either GPS or cell tower triangulation).  Further, I thought, maybe the speaker in the Auvi-Q could be made into a two-way transceiver facilitating direct conversation with emergency personnel.  I started researching and wouldn’t you know it… these Auvi-Q guys thought of all that already and put it in their patent!

So maybe we’re only seeing Phase I of the Auvi-Q.  The patent also allows for automatic notification to the user’s doctor, automatic updating of health records with details of the situation, etc.  The patent also applies to asthma inhalers, which seems to be where this automatic updating of health records comes in.  If a patient didn’t have to guess or remember how often, when, and under what conditions he or she used an asthma inhaler, wouldn’t that be great for their medical care?  I’m getting off topic here.  The point is that “the Auvi-Q boys” (and their Sanofi friends) seem to have thought of a lot here.  Kudos to them for their efforts!

It’s probably clear by now, but after 2 weeks with the Auvi-Q’s I am extremely impressed!  Enough so that it has become my primary epinephrine device when out with my children (though I will continue carrying Epi-Pens as well on occasion).  But that’s just me.  There are certainly benefits of carrying Epi-Pens instead of Auvi-Q’s that may be more important to others.

So let me review what I see as the positives of each device.  These comments are of course just my own opinion and are not all-encompassing.  Once again, consider them as you will.

Benefits of the Auvi-Q: small size, audio capabilities, easy to read instructions on the casing, easier to use for people unfamiliar with epinephrine auto-injectors, likely greater compliance among teens (especially boys), no need to jab the needle, 5 second injection versus 10, less likely that an administrator will jab his or her finger.

Benefits of the Epi-Pen: proven device, millions of people – including school personnel, camp counselors, family friends, and other – have been trained on it and know how to use it, lower price, more likely to be found quickly in a purse or backpack, being bigger may actually make it easier for a user to also carry Benadryl or other appropriate medication.

The bottom line here is that the introduction of the Auvi-Q has offered a real, legitimate alternative to the traditional Epi-Pen.  Some may choose to stay with their Epi-Pens for various reasons and some may switch.  But it’s nice to have a choice!

One other benefit of the Auvi-Q is that it seems to have caused Mylan to get very aggressive on “special deals” for the Epi-Pen.  Just as Sanofi is offering to subsidize the purchase of the Auvi-Q such that a buyer won’t have to pay more than $25 for his/her prescriptions (with restrictions, of course), Mylan has just begun offering a co-pay card that will reimburse an Epi-Pen buyer for up to $100 (also with restrictions).  In addition, Mylan continues to offer its EpiPen4Schools program to provide free and discounted Epi-Pens to qualified schools.  Who says competition isn’t great for the consumer?!

So what do you think of all this (and lay off any comments about picture or video quality)?  Are you excited about the Auvi-Q?  Would you carry Auvi-Q’s now instead of Epi-Pens or would you want to hear success stories first?  Have you gotten Auvi-Q’s already and what do you think?  Which benefits or shortfalls of each device resonate most with you?  Lay it on us and share your thoughts in the Reply box below.  I can’t wait to hear what you have to say!

And since I have your attention, please allow me to make a plea for you to visit the core AllergyEats site (www.allergyeats.com) or free AllergyEats smartphone app to rate any recent dining experiences you’ve had.  Rating a restaurant takes just a minute, but each new rating makes AllergyEats an even more valuable too for our entire food allergy and intolerance community!