Could this be a game-changer for anaphylaxis treatment? For the first time in over three decades, Australians have a new way to administer adrenaline, and it’s not an injection. The Therapeutic Goods Administration (TGA) has approved Neffy, an adrenaline (epinephrine) nasal spray, sparking both excitement and questions in the medical community. But here’s where it gets controversial: while some hail it as a breakthrough, others wonder if it’s truly worth the higher price tag compared to traditional methods like the EpiPen. Let’s dive in.
Why the buzz? Neffy offers a needle-free alternative for treating anaphylaxis, a life-threatening allergic reaction that requires immediate intervention. Professor Connie Katelaris AM, a leading NSW allergist, welcomes the innovation: ‘Anaphylaxis is notoriously challenging to manage, and having another option is a step forward. Patients in Australia now have access to something that’s been available overseas for years.’ But is it as effective? And who stands to benefit most?
How does Neffy work? Like the EpiPen, Neffy delivers adrenaline, the critical ingredient for halting anaphylaxis. However, instead of an injection, it’s administered through the nasal mucosa, allowing for rapid absorption into the bloodstream. This method is similar to opioid reversal medicines, making it a familiar concept for healthcare providers. But this is the part most people miss: Neffy is currently a Prescription-only (Schedule 4) medication, meaning it can’t simply replace injectable adrenaline in standard resuscitation kits, which typically contain Schedule 3 items.
Who is it for? Neffy is approved for patients aged 4 and older, weighing at least 15 kg, making it particularly appealing for needle-phobic individuals, especially young children. It comes in two strengths: 1 mg for patients weighing 15–30 kg and 2 mg for those 30 kg or more. However, it’s not suitable for children under 4 or those under 15 kg, where adrenaline auto-injectors remain the go-to option.
What are the risks? While adrenaline is a lifesaver, Neffy isn’t without potential side effects. Patients with conditions like raised intraocular pressure, severe renal impairment, or cardiovascular disease may face higher risks. Pregnant individuals, older adults, and those with Parkinson’s disease should also exercise caution. Interestingly, the nasal spray’s effectiveness in patients with structural nasal issues (like polyps or past nasal surgeries) remains uncertain, as these groups were excluded from clinical trials.
Cost and accessibility: The real debate At $194 for a box containing two sprays, Neffy is about 20% pricier than the EpiPen. CSL Seqirus, the manufacturer, has applied for it to be listed on the Pharmaceutical Benefits Scheme (PBS), but a decision won’t come until March 2026. Meanwhile, the company is also seeking to downschedule Neffy to Schedule 3, which could make it more accessible. But here’s the question: Is the convenience of a nasal spray worth the extra cost, especially when injections have proven effective for decades?
Final thoughts and your turn Neffy undoubtedly offers a promising alternative for anaphylaxis treatment, particularly for those wary of needles. However, its higher cost and limited suitability for certain groups raise important questions. Should it replace traditional methods, or is it better as a complementary option? And should it be more affordable to ensure broader access? Let us know your thoughts in the comments—we’d love to hear your perspective on this groundbreaking yet controversial development.
