ARS Pharma to provide free neffy epinephrine nasal spray to schools
Key takeaways:
- 4 million children in the United States have a food allergy.
- The neffyinSchools program provides four free doses of neffy.
- Schools are advised to consult state and local laws on stocking and administration.
The neffyinSchools program from ARS Pharma will provide eligible public and private K-12 schools in the United States with two cartons of the company’s neffy epinephrine nasal spray, including a total of four single-use doses, for free.
Schools can use these 2 mg doses of neffy to treat anaphylaxis and other type 1 allergic reactions in adults and children who weigh 66 lbs or more. Once these doses are used or expired, schools can receive replacement doses.
“It is estimated that one-quarter of anaphylactic reactions in schools are among students with previously undiagnosed allergies. Studies also show that food allergies affect approximately 1 in 20 school-aged children,” Richard Lowenthal, MS, MSEL (MBA), cofounder, president and CEO of ARS Pharma, told Healio.
These figures underscore the importance of making epinephrine readily available for nurses and other trained school personnel to administer to those in need.
“The neffyinSchools program will help eligible schools to obtain epinephrine free of cost. This better prepares schools to provide emergency treatment with a needle-free nasal epinephrine spray for severe allergic reactions,” Lowenthal said.
According to the Allergy and Asthma Foundation of America (AAFA), 4 million children in the United States have a food allergy.
“These children spend a significant portion of their days in schools, where they may be exposed to allergens that may trigger anaphylaxis, a severe allergic reaction, which, untreated, can potentially cause a rare, fatal outcome,” Jenna Riemenschneider, BA, MS, vice president of advocacy and policy at AAFA, told Healio.
Latex, insect stings and some medicines also may cause anaphylaxis, Riemenschneider continued. Epinephrine is the first-line treatment for anaphylaxis triggered by any of these allergens, she added, and it must be promptly administered at the first sign of an anaphylactic reaction to prevent it from progressing.
But while most states have passed laws that allow schools to stock epinephrine, AAFA reported in its 2025 State Honor Roll of Asthma and Allergy Policies for Schools that only 10 states require schools to stock epinephrine, leaving children at risk.
“AAFA has and will continue to support state and local policies that require epinephrine stocking at schools,” Riemenschneider said. “We believe epinephrine should be available at all schools at all times, and this program could help make that more possible.”
However, most state laws specifically reference epinephrine autoinjectors, Riemenschneider clarified.
“AAFA encourages states to adopt changes to their laws to allow any FDA-approved easy delivery epinephrine to be stocked,” she said, noting that sublingual forms of epinephrine delivery are in development now as well.
“School districts should have access to all epinephrine administration options for use in their schools,” Riemenschneider said.
Barriers that prevent or deter schools from stocking epinephrine include concerns about liability, costs, access to epinephrine, school nurse staffing, training and challenges related to prescribers, according to an American Academy of Allergy, Asthma & Immunology work group.
Lowenthal encouraged school districts to review applicable state legislation to ensure that neffy meets requirements for stocking and administration in undesignated use.
“These laws are in place to indemnify the school personnel, so if someone chooses to take legal action against them, they are protected as a good Samaritan,” he said.
Lowenthal also said that neffy can provide life-saving treatment without the fear or hesitation that needle-based delivery such as autoinjectors may provoke, with studies indicating that two out of three children are afraid of needles.
“Because of its needle-free design, we believe school nurses, educators and administrators will use neffy earlier with less hesitation, making schools safer and better prepared to address anaphylaxis,” Lowenthal said.
The nasal spray also eliminates risks for needle-related injuries for both patients and caregivers, he continued, with disposal in the trash instead of in containers designed for sharps.
Further, Lowenthal cautioned that neffyinSchools is only for undesignated use.
“Children with prescriptions for epinephrine from their health care provider must continue to supply medication to their school in accordance with school guidelines,” Lowenthal said.
Looking ahead, Lowenthal noted that the 1 mg formulation of neffy is under priority review with the FDA, with a Prescription Drug Use Fee Act date of March 6.
“If approved, neffy 1 mg will be available to schools for students who weigh between 33 and 66 lbs,” he said.
Although neffy was designed to be easy to use with no training required, some states may require training for school nurses and administers, Lowenthal said. ARS Pharma has held two educational webinars regarding neffy usage so far, drawing interest from more than 4,000 school nurses and administrators.
ARS Pharma plans on hosting additional webinars this year, Lowenthal said. Plus, the blister pack includes instructions that have been approved by the FDA as well as a QR code that links to an instructional video.
“There are additional educational resources available on neffypro.com,” Lowenthal said.
Lowenthal also cited online resources available from AAFA as well as other organizations, including Food Allergy Research & Education, the Allergy & Asthma Network, and the Food Allergy & Anaphylaxis Connection Team.
“Our goal is to ensure children in schools have access to potentially life-saving epinephrine now and in the future,” Riemenschneider said.
Feedback for the program has been “overwhelmingly positive” so far, according to Lowenthal.
“We are very pleased that the educational community is embracing neffy to keep students safe,” he said.
More information about neffyinSchools is available online. Interested school districts can apply to the program online.
Reference:
- Conley ME, et al. 2025 State Honor Roll: Asthma and allergy policies for schools; https://aafa.org/wp-content/uploads/2025/01/aafa-2025-state-honor-roll-report.pdf. Published Jan. 14, 2025; Accessed Feb. 11, 2025.
- Russell AF, et al. J Allergy Clin Immunol Pract. 2023;doi:10.1016/j.jaip.2022.12.047.