Can I swap my EpiPen for neffy on the PBS from 1 July?

Neffy is now PBS-listed, so your GP can prescribe it at the standard co-payment. Whether to switch from an injectable adrenaline device to neffy, or to carry both, depends on your specific allergy profile, individual preferences, and any history of anaphylaxis. Discuss the options at your next appointment — neffy is approved for adults at significant anaphylaxis risk and for children over four years weighing at least 15 kg.

Is neffy as effective as an EpiPen during a severe allergic reaction?

The TGA approved neffy based on pharmacokinetic data showing adequate epinephrine absorption via the nasal route. Intramuscular injection via auto-injector retains the longest real-world safety record and remains the benchmark. Neffy may perform less effectively when significant nasal congestion is present — such as during active rhinitis or nasal symptoms early in an allergic reaction. Your GP and ASCIA guidelines can help guide the right choice for your circumstances.

Needle-free adrenaline on the PBS from 1 July — what changes

What just happened

From 1 July 2026, Australians at documented anaphylaxis risk can access neffy — an epinephrine nasal spray — on the Pharmaceutical Benefits Scheme for the first time. It is the first needle-free adrenaline delivery device to reach PBS subsidy in Australia. Without the listing, a two-pack cost more than $95; at the standard co-payment, that barrier is substantially reduced.

Neffy delivers either 1 mg or 2 mg of epinephrine intranasally per dose and is TGA-registered for adults at significant anaphylaxis risk and for children over four years weighing at least 15 kilograms. It comes as a pack of two doses — the standard structure mirrors current guidance to administer a second dose of adrenaline if the first is insufficient and emergency services have not yet arrived.

Dr Nick Cooling, one of the GPs quoted in the RACGP newsGP coverage, described neffy as “the biggest thing that’s changed in adrenaline in the last 20 years.” That is a significant claim for a device where the molecule has not changed at all — only the route of administration. The context is real: hospital presentations for anaphylaxis in Australia rose by 51%, and admissions rose by 35%, between 2015 and 2020. The problem neffy is being asked to help solve — inadequate carry rates and delayed administration of adrenaline — is not hypothetical.

The both-and

Why this matters beyond the device itself

Needle aversion is not a trivial preference. Research in people prescribed injectable adrenaline consistently shows that a significant proportion do not carry their device reliably, and that delayed or absent use during anaphylactic events contributes to preventable deaths. For some patients, the barrier to carrying an EpiPen is practical — the size, the storage, the training burden. For others, it is the needle: anxiety about self-injecting under duress, or injecting a panicking child.

Early adrenaline administration is the most important determinant of outcome in anaphylaxis. ASCIA guidelines are unambiguous on this point: the device is only useful if it is carried and used at the right moment. A device that more patients are willing to carry, and more comfortable using, has genuine potential to improve those rates — not because it is pharmacologically superior to the EpiPen, but because adherence to emergency preparedness is its own clinical variable.

For GPs, the PBS listing also opens a conversation about prescribing strategies. Some allergists advocate for prescribing plans that position neffy as the first-line device for patients with documented needle aversion, with injectable adrenaline as a backup. Others maintain injectable adrenaline as the primary recommendation and treat neffy as a parallel option. NPS MedicineWise guidance on epinephrine devices may be updated to reflect the new option; GPs should watch for that.

The questions that still need watching

The nasal route has physiological nuances. Epinephrine absorption through nasal mucosa depends on the integrity of that mucosa — active nasal congestion from rhinitis, respiratory infections, or early nasal symptoms of an allergic reaction could theoretically reduce the rate and completeness of absorption. The TGA approved neffy on the strength of pharmacokinetic data demonstrating adequate plasma epinephrine levels, but real-world comparative data with intramuscular injection — especially in paediatric populations or patients with chronic rhinitis — is still accumulating.

The EpiPen and its generics are not being replaced. Intramuscular epinephrine via auto-injector retains the strongest guideline backing and the longest real-world safety record. Patients currently prescribed injectable adrenaline should not switch without a GP discussion about whether neffy is appropriate for their specific situation. The useful clinical question is not “which is better?” but “which device am I most likely to carry, and most likely to use correctly at the critical moment?“

2 cents

If you or someone in your family manages a documented allergy risk — food, insect venom, latex, or medication — and has ever hesitated to carry adrenaline because of needle anxiety, this week’s news is worth raising at your next general practice appointment. The PBS listing means the conversation can now include a genuine needle-free option at an accessible cost.

That is not a small shift for the subset of patients where needle aversion has previously meant going without. Carry rates matter. The device on the shelf does not save anyone.

Verdict: yes — worth knowing about.

Sources cited

RACGP newsGP — Neffy added to PBS. June 2026. https://www1.racgp.org.au/newsgp/clinical/neffy-added-to-pbs
Therapeutic Goods Administration (TGA). https://www.tga.gov.au/
Australasian Society of Clinical Immunology and Allergy (ASCIA). https://www.allergy.org.au/
NPS MedicineWise. https://www.nps.org.au/