Updated February 2025 – Patients with food, drug and stinging insect allergies are increasingly able to get prescriptions filled for the neffy epinephrine sprayer.
In September 2024, ARS Pharmaceuticals announced that neffy, the first non-needle treatment for severe allergic reactions, had become available in U.S. pharmacies. Neffy sprayers were also being shipped from an online pharmacy to patients who ordered on neffy.com.
“Pharmacies are processing prescriptions, our supply chain is fully operational, and most importantly, patients are now receiving neffy,” says ARS Pharma’s Chief Commercial Officer Eric Karas.
The Food and Drug Administration approved neffy in August 2024 for adults and children weighing 66 pounds and up. Since the approval, ARS Pharma’s President and CEO Richard Lowenthal says “the level of excitement has been very high.”
With the FDA’s green light, the company ramped up manufacturing and started shipping to pharmacy distributors.
In the early days of the neffy rollout, many commercial health plans had yet to include the novel device on their prescription formularies. However, by late February 2025, insurance coverage was expanding rapidly. ARS Pharma recently announced neffy’s inclusion on three key insurance formularies, saying that 30 insurer platforms were now covering the sprayer.
How to Get Neffy Sprayers
ARS Pharma stated that “Cigna Healthcare, Navitus Health Systems and OptumRx, through their group purchasing organization Emisar, have added neffy to their national formularies.”
“Millions of patients nationwide now have improved access to neffy through their commercial insurance,” said Lowenthal. Addressing the February formulary approvals, he says neffy sprayers will be available at the lowest copay for those insured by OptumRx, Cigna Healthcare and Navitus Health Systems – “without the need for prior authorizations or restrictive step therapies.”
In December 2024, the huge Express Scripts pharmacy benefit manager also added neffy sprayers to its formularies.
Patients have a couple of options for ordering neffy epinephrine sprayers, which come in a pack of two. You can go see your allergist, request a neffy prescription and have it filled through your regular retail pharmacy.
A second option for patients is to go to neffy.com. There, you can upload your prescription for neffy sprayers and receive the medication in the mail from an online pharmacy, BlinkRx. Patients who need a prescription can also schedule an online appointment with a telehealth provider for $35 on neffy.com.
Neffy Pricing, Shelf Life
Patients with insurance coverage for neffy may pay as little as $25 for a two-pack of neffy sprayers by using this coupon.
For people without insurance or whose insurance will not cover neffy, the cash price for a two-pack is $199. People below certain income thresholds may also qualify to receive neffy at no charge through a patient assistance program.
For insurance plans that don’t yet list neffy epinephrine sprayers on their formularies, physicians can request prior authorization for patients. The ACAAI allergists’ organization has even created this letter generator to assist. Or, ARS Pharma will facilitate this for patients who order the medication through neffy.com.
Neffy’s shelf life, or expiration date, is 30 months. By comparison, epinephrine auto-injectors expire after 12 to 18 months.
Studies Behind Neffy Sprayers
Neffy’s approval was based on four studies in 175 healthy adults not experiencing anaphylaxis. The studies compared concentrations of epinephrine in the blood after using the neffy sprayer and after administering an epinephrine auto-injector or a manual syringe.
The results of these studies showed comparable epinephrine blood concentrations between neffy and epinephrine injection products. The FDA says neffy also showed similar increases in blood pressure and heart rate as the epinephrine injection devices.
Lowenthal credits the dedication of the allergy community and healthcare providers for paving the way for neffy as the first needle-free epinephrine treatment for severe allergies. “Now that people can begin using neffy, we are looking forward to seeing how it positively impacts the approximately 20 million people in the U.S. who experience severe allergic reactions.”
Neffy for Smaller Kids, Europe Update
ARS Pharmaceuticals has also submitted a supplemental new drug application to the FDA for a 1 mg neffy sprayer for smaller children weighing 33 to 66 pounds. The FDA has until early March 2025 to issue its decision on the lower dose for kids.
If approved, Lowenthal expects the 1 mg dose for smaller kids will be available by May 2025.
ARS Pharmaceuticals also inked a licensing deal with a pharmaceutical partner in Europe to make neffy available there.
In August 2024, the European Commission approved EURneffy for the emergency treatment of allergic reactions in the European Union. The company expected EURneffy to be available in Germany at the end of 2024, followed by some other EU countries.
ARS Pharma has also filed for approval in the United Kingdom with regulators there. A streamlined process should deliver an approval decision in the U.K. by the spring, Lowenthal says.
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