Epinephrine nasal spray Neffy has generated $72.2 million in sales within its first year on the market, a figure that reflects both the demand for alternative anaphylaxis treatments and the company’s efforts to secure insurance coverage. The drug, developed by ARS Pharmaceuticals, is available to commercially insured patients through major pharmacy benefit managers. United Healthcare, Express Scripts, Cigna, Optum Rx, and TRICARE all offer the medication without restriction, while several Blue Cross plans and CVS Caremark require prior authorization for access.
Sales reached $72.2 million in the first full year of availability. More than 28,000 healthcare providers have prescribed the nasal spray, with roughly half of those being repeat prescribers. Patients with commercial insurance can obtain two packs, or four devices, for a $0 copay. Medicaid coverage varies by state, but nine jurisdictions, including Texas and Florida, provide unrestricted access. Most other states or commercial plans that do not cover the drug automatically require prior authorization.
How the product works and market data
Neffy treats severe, life-threatening allergic reactions known as anaphylaxis in adults and children weighing 33 pounds or more. The condition can be triggered by foods like shellfish and tree nuts, as well as insect stings, and symptoms often include hives, difficulty breathing, and loss of consciousness. The only approved treatment for these reactions remains epinephrine, which was previously available only as an injection.
For those without insurance, a cash price of no more than $199 is available at local pharmacies, online platforms like BlinkRx, or the company’s website getneffy.com. The company also supplies the medication to schools through the neffyinSchools program, where over 10,000 institutions have received two cartons of 2 mg or 1 mg devices at no cost. More than 200 successful uses have been reported in school settings.
Expanding beyond emergency use
Research continues on Neffy for conditions beyond anaphylaxis. ARS Pharmaceuticals is currently conducting a phase 2b trial focused on a low dose of the nasal spray for patients with acute flares of chronic spontaneous urticaria (CSU). This condition causes hives and tissue swelling and affects approximately 1.5 million people in the United States, with about 900,000 experiencing uncontrolled symptoms. No treatment is currently approved specifically for these acute flares.
Interim results from the CSU trial are expected in the fourth quarter of 2026, followed by a single phase 3 efficacy study in mid-2027. The company stated that it is committed to expanding access to Neffy for patients at risk of severe allergic reactions and continues to work with payers to broaden coverage. [1]Service Apologizes for Blocking Users
