ADRENALINE AUTO INJECTORS IN ALL SCHOOLS COULD SAVE LIVES SAYS NEW STUDY

National Allergy Strategy Group

Funding “spare” adrenaline autoinjectors (such as EpiPen or Jext devices) for all UK schools could save the NHS millions while protecting children at risk of anaphylaxis—a landmark study reveals substantial impact if the scheme was to be funded nationally.

The study led by Dr Paul Turner, Professor of Anaphylaxis at Imperial College London and published online in the Archives of Disease in Childhood, provides compelling evidence that UK schools could improve emergency care for allergic children and save the NHS at least GBP4.6 million annually, by centrally funding “spare” adrenaline autoinjectors for use in schools.

“Around 3% of school-aged children in England are at risk of food-induced anaphylaxis, with most experiencing at least one accidental allergic reaction every 2–3 years. Since 2017, schools have been able to obtain ‘spare’ adrenaline ‘pens’ for emergencies, but uptake remains low. Schools often have to pay over GBP100 for each device because they don’t receive them for free,” says Dr Turner, who is also Vice-Chair of the National Allergy Strategy Group (NASG). NASG are advocating for improved health and quality of life for people living with all types of allergies across the UK and will launch the first UK national allergy strategy in 2026.

“The study highlights a key area of opportunity for schools to be able to obtain adrenaline ‘pens’ in a cost-effective way, to improve the safety of children at risk of anaphylaxis” says Dr Turner.

The UK Government recommends children at-risk of anaphylaxis carry two adrenaline autoinjectors at all times. However, schools often require pupils to leave two devices on school premises. This results in many children being dispensed more than two adrenaline “pens” —over 60% of those prescribed AAIs received more than four devices in 2023/24. Most of these additional autoinjectors are for school use but are rarely used —adding unnecessary costs to the NHS and slowing down treatment in emergencies as teachers have to match the right “pen” to the right pupil.

The research team conducted a nationwide modelling study, analysing NHS datasets and prescription trends for the academic years 2023/24 and 2024/25. Results show that current practice—dispensing extra adrenaline “pens” for pupils to leave at school—costs the NHS upwards of GBP9 million per year. By contrast, were all schools to receive at no cost four “spare” adrenaline “pens”, this would cost just GBP4.5 million annually.

Aside from cost savings, the scheme could save lives: Any pupil experiencing anaphylaxis—regardless of whether they’ve been diagnosed as being at risk—would have immediate access to emergency medication, preventing delays which can contributed to fatal outcomes.

Benefits for Schools, Families, and Patient Safety

• Cost-neutral for most NHS Integrated Care Boards (ICBs): Over 90% of regions would break even or save money, with some areas saving up to GBP400,000 yearly.
• Improved emergency access: “Spare” adrenaline autoinjectors could be used in any child having anaphylaxis, including those without a prior diagnosis or prescription—a critical factor since one-quarter of food-anaphylaxis reactions happen in schoolchildren without a diagnosis of food allergy.
• Logistical simplicity: Schools need only stock a single brand of autoinjector, reducing confusion and delays during emergencies. Central supply would ensure devices are in-date and replaced systematically.
• Reduced NHS waste: While over 2.3 million autoinjectors are dispensed in the UK each year, only about 2% are used. Centralised provision would streamline orders and help avoid shortages in the supply chain which have affected the UK numerous times in the past few years.

Echoing successful models in Australia, Canada and USA

The study follows recommendations from HM Coroners investigating recent tragic deaths and echoes successful models in Australia, Canada, and the United States, where government funding has already reduced risks and improved outcomes for allergic children.

The findings have been welcomed by Helen Blythe of the Benedict Blythe Foundation. “Across the country, regional pilots and local initiatives have shown that it is possible, practical, and financially sound to equip schools with adrenaline ‘pens’. Such a strategy would improve emergency access to adrenaline to all pupils, irrespective of whether they have been diagnosed with food allergy.”

Notes for editors
Research: Economic modelling of providing ‘spare’ adrenaline autoinjectors to all schools to improve the management of anaphylaxis Doi: 10.1136/archdischild-2025-329493
Viewpoint: Spare pens save lives—so why aren’t they in every school? Doi: 10.1136/archdischild-20225-329521


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