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Lookup NU author(s): Dr Louise MichaelisORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.Objective To analyse NHS health datasets to estimate the cost of providing emergency adrenaline [epinephrine] autoinjectors (AAIs) to school pupils on a named-patient basis to leave on school premises versus providing ‘spare’ AAIs to schools which can be used for any school pupil. Design Retrospective cohort study. Setting English primary electronic health data from the Clinical Practice Research Datalink (CPRD) and English prescriptions data from the NHS Business Services Authority. Participants School-aged children in England. Main outcome measures (1) Proportion of school children with food allergy prescribed AAI; (2) cost of providing more than two AAIs to individual pupils mapped to integrated care boards (ICBs) in England compared with the cost of providing four spare AAIs to every school for the academic year 2023/24. Results 44% of school-aged children in the CPRD had at least one AAI prescription and only 34% had repeat AAIs prescribed. In pupils with previous anaphylaxis, rates were 59% and 44%, respectively. During the academic year 2023/24, 63% of pupils were dispensed more than two AAIs at an estimated cost of over £9 million. The estimated cost of providing spare AAIs to every school was £4.5 million. If spare AAIs were to replace the supply of named-patient AAIs exclusively to leave on school premises, this would represent a potential cost-saving of at least £4.6 million or 25% of the total national expenditure for AAIs. Conclusions Under half of children at risk of anaphylaxis are prescribed AAIs. Providing spare AAIs to all schools (at no cost to the school) would be a cost-neutral strategy for the vast majority of ICBs and one that is likely to improve emergency access to AAIs and therefore safety.
Author(s): Turner PJ, Bright A, Michaelis LJ, Quint JK
Publication type: Article
Publication status: Published
Journal: Archives of Disease in Childhood
Year: 2025
Pages: epub ahead of print
Online publication date: 21/10/2025
Acceptance date: 12/09/2025
Date deposited: 10/11/2025
ISSN (print): 0003-9888
ISSN (electronic): 1468-2044
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/archdischild-2025-329493
DOI: 10.1136/archdischild-2025-329493
Data Access Statement: Data may be obtained from a third party and are not publicly available. Data may be obtained from a third party and are not publicly available. Data sets used in this analysis were obtained via a Clinical Practice Research Datalink (CPRD) institutional licence. Requests for data should be made directly to the CPRD via their online application portal (https://cprd.com/researchapplications).
PubMed id: 41120194
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