Simons F Estelle R
Department of Pediatrics and Child Health, Canadian Institutes of Health Research National Training Program in Allergy and Asthma, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba.
Ann Allergy Asthma Immunol. 2009 May;102(5):403-9. doi: 10.1016/S1081-1206(10)60512-1.
Epinephrine (adrenaline) is an essential medication for the treatment of anaphylaxis. Epinephrine auto-injectors are universally recommended as first-aid treatment for anaphylaxis occurring in community settings. In a World Allergy Organization survey conducted in 2003, auto-injectors containing 0.3 mg of epinephrine were reported to be available in 56.4% of countries and those containing 0.15 mg of epinephrine were reported to be available in 43.6% of countries. Auto-injectors containing an infant dose were not available in any country. The cost of 1 auto-injector ranged from US $30 to US $110.
To ascertain if availability and affordability of epinephrine auto-injectors had improved worldwide between 2003 and 2007.
The survey instrument designed for use in 2003, with 2 additional questions, was self-administered by allergy/ immunology specialists in the 2007 World Allergy Organization House of Delegates. Responses were tabulated by country.
Completed surveys were received from 1 or more representatives of all 44 countries with voting delegates (100% response rate). At the time of the survey, auto-injectors containing 0.3 mg of epinephrine and auto-injectors containing 0.15 mg of epinephrine, were available through official distribution channels in 26 (59.1%) of 44 countries (95% confidence interval for percentage of countries, 43.2%-73.7%). Auto-injectors containing an infant dose were still not available in any country. The unsubsidized median cost of 1 auto-injector was US $97.87 (range, US $54.50-US $168.66).
Since 2003, the global availability of auto-injectors containing 0.3 mg of epinephrine has improved slightly. The availability of those containing 0.15 mg of epinephrine has improved more. Auto-injector costs have increased. The lack of availability and affordability of epinephrine auto-injectors for the first-aid treatment of anaphylaxis in the community remains a concern in many countries.
肾上腺素是治疗过敏反应的一种重要药物。肾上腺素自动注射器被普遍推荐作为社区环境中发生过敏反应的急救治疗方法。在2003年世界过敏组织开展的一项调查中，据报告，56.4%的国家有含0.3毫克肾上腺素的自动注射器，43.6%的国家有含0.15毫克肾上腺素的自动注射器。没有一个国家有含婴儿剂量的自动注射器。1个自动注射器的成本在30美元至110美元之间。
确定2003年至2007年期间全球肾上腺素自动注射器的可获得性和可负担性是否有所改善。
2007年世界过敏组织代表大会上，过敏/免疫学专家自行填写了2003年设计使用的调查问卷，并增加了2个问题。按国家对回答进行了列表统计。
收到了所有44个有投票代表国家中1名或多名代表填写的完整调查问卷（回复率100%）。在调查时，44个国家中有26个（59.1%）国家（各国百分比的95%置信区间为43.2%-73.7%）通过官方分销渠道可获得含0.3毫克肾上腺素的自动注射器和含0.15毫克肾上腺素的自动注射器。没有一个国家仍没有含婴儿剂量的自动注射器。1个自动注射器的无补贴中位数成本为97.87美元（范围为54.50美元至168.66美元）。
自2003年以来，含0.3毫克肾上腺素的自动注射器在全球的可获得性略有改善。含0.15毫克肾上腺素的自动注射器的可获得性改善更大。自动注射器成本有所增加。在许多国家，社区中用于过敏反应急救治疗的肾上腺素自动注射器缺乏可获得性和可负担性仍是一个令人担忧的问题。
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