{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:05:13Z","timestamp":1789362313313,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Allergy"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anaphylaxis is a serious systemic hypersensitivity reaction requiring prompt recognition and treatment, yet diagnosis-linked national surveillance is unavailable in many countries. Epinephrine auto-injector (EAI) dispensing cannot identify confirmed events or individual patients, but it is an epidemiologically relevant medication-use endpoint because EAIs are supplied to people with prior anaphylaxis or a clinically judged risk of future anaphylaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify nationwide EAI dispensing in Greece as a drug-utilization and emergency-treatment-preparedness benchmark and, secondarily, derive scenario-based incidence-compatible and prevalence-equivalent indicators relevant to the epidemiology of anaphylaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This nationwide retrospective drug-utilization study analyzed aggregated net Anapen\u00ae DUO pack counts from reimbursed and non-reimbursed retail and hospital pharmacy channels during March 2015-March 2017, when it was the only EAI marketed nationally. Directly observed pack flow was primary, utilization by EAI strength was analyzed at the population level using age-equivalent denominators, expiry timing was examined conditionally, and scenario outputs were deterministic sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 25 months, 33,986 twin-packs were recorded (153.2 packs per 100,000 person-years). The final 12-month rate was 154.0 per 100,000 population. Using age-equivalent population denominators, 150-microgram dispensing intensity was 5.8-fold higher than 300-microgram intensity. Reference scenarios yielded an incidence-compatible anaphylaxis indicator of 47.7\u2013125.3 episodes per 100,000 person-years and prevalence-equivalent active EAI coverage of 51.7\u2013133.0 persons per 100,000. Deliberately broader assumption ranges widened these to 17.0\u2013229.8 and 19.7\u2013177.3, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nationwide EAI dispensing provides the first all-age benchmark of access to community emergency epinephrine in Greece. By combining observed pack flow with transparent scenario-based analyses, this study introduces a reproducible approach for gaining insights into anaphylaxis epidemiology and emergency-treatment preparedness from national dispensing data, particularly where comprehensive registries are unavailable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/falgy.2026.1906574","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:38:42Z","timestamp":1789360722000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nationwide epinephrine auto-injector dispensing in Greece: a drug-utilization study providing insights into anaphylaxis epidemiology and emergency-treatment preparedness"],"prefix":"10.3389","volume":"7","author":[{"given":"George N.","family":"Konstantinou","sequence":"first","affiliation":[{"name":"Department of Allergy and Clinical Immunology, 424 General Military 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