Model anaphylaxis policy, epinephrine cost cap advanced

Lawmakers gave first-round approval March 12 to a bill intended to ensure that children with life-threatening allergies are safe in school and licensed child care environments.

LB457, sponsored by Lincoln Sen. Eliot Bostar, would require the state Department of Health and Human Services, in consultation with the state Department of Education, to develop statewide guidelines for prevention, individualized health plans, emergency response and communication regarding anaphylaxis.

Under the bill, school districts and licensed child care facilities that include children with known allergies must adopt and publish a policy on anaphylaxis by July 1, 2026.

Bostar said Nebraska lacks a comprehensive statewide policy on anaphylaxis, which can have deadly consequences for children if treatment is delayed or improperly administered. More than 36,000 children in the state have food allergies, he said, and institutions that care for children need to be aware of best practices regarding how to respond to severe allergic reactions.

Bostar said the bill also seeks to make epinephrine auto-injectors, often known by the brand name EpiPen, more accessible and affordable for the nearly 200,000 families in Nebraska dealing with severe allergies by capping out-of-pocket expenses.

LB457 would require any individual or group sickness and accident insurance policy that provides reimbursement for prescription medically necessary epinephrine injectors to limit the total amount that a covered individual is required to pay for a two-pack of covered injectors to no more than $60 regardless of the amount or type of epinephrine injector needed.

Currently, the cost of a twin-pack of EpiPens ranges from $630 to $750, depending on the pharmacy, Bostar said, making the only medication that can save their lives unaffordable for many Nebraskans.

“The absence of a cure for life-threatening allergies underscores the critical importance of epinephrine auto-injectors for preventing fatal anaphylaxis,” he said.

Lawmakers voted 31-0 to advance the bill to select file.