Committee hears bill to add nasal‑spray epinephrine to school and camp statutes

Representative Bridal Leon, the prime sponsor, opened the hearing on House Bill 63, saying the bill updates existing statutes to allow the newly approved epinephrine nasal spray to be used in the same places where epinephrine auto‑injectors are already permitted.

The bill revises school and camp statutes to give parity to the nasal spray and adds a provision clarifying that a pharmacist may dispense epinephrine auto‑injectors and epinephrine nasal spray pursuant to a prescription issued in the name of a school, post‑secondary institution, or independent school. Representative Bridal Leon said that language was added after pharmacists expressed uncertainty about whether they could fill a prescription written to a school.

Jonathan Ballard, chief medical officer for the New Hampshire Department of Health and Human Services, testified about clinical and coverage considerations. Ballard said the nasal spray is an approved alternative “particularly among needle phobic or children who are scared of needles,” but told the committee the formulation has a strict prior authorization requirement for Medicaid. He gave cost figures the committee could apply to budget and access discussions, saying, “The auto injector currently is $45 to the Medicaid program. The nasal spray is $710 per dose.” Ballard said the high cost has led to prior authorization and restricted coverage to a narrow set of clinical circumstances.

Committee members asked whether the bill would mandate schools to buy the nasal spray; Representative Bridal Leon and Ballard clarified the statute would allow, not require, schools and camps to accept the formulations. Ballard also confirmed the child’s prescription remains the child’s medication and that parents or insurers typically bear the cost unless other arrangements are made. Members discussed whether to avoid naming delivery routes explicitly; one senator proposed amending the statute to refer simply to “epinephrine” to accommodate future delivery forms. Representative Bridal Leon supported that change as a potential improvement.

Representative Bridal Leon said the bill is written to take effect upon passage so camps can have the nasal spray in time for summer programs, noting the sprays tolerate heat in vehicles better than some auto‑injectors. No formal motion or vote on the bill occurred during the hearing.

The committee closed the hearing after questions and did not take immediate action.