Neffy’s first year: $72.2m in sales, 10,000 schools and broadening payer access

Within the first year of becoming available, Neffy, an epinephrine nasal spray available for anaphylaxis, has generated $72.2 million in sales and has become widely accessible to commercially insured patients, including some of the largest pharmacy benefit managers. United Healthcare, Express Scripts, Cigna, Optum Rx and TRICARE all offer Neffy without restriction, a company spokesperson said. Several Blue Cross plans and CVS Caremark and other insurers provide coverage of Neffy with prior authorization.

Developed by ARS Pharmaceuticals, Neffy is used as an emergency treatment of type 1 allergic reactions, including anaphylaxis, in adults and children who weigh 33 lbs. or greater. Type 1 allergic reactions include anaphylaxis, which is a severe, life-threatening allergic reaction that can be caused by foods such as shellfish, tree nuts, or insect stings. Symptoms may appear as hives, itching, vomiting, difficulty breathing and loss of consciousness. The only treatment for anaphylaxis is epinephrine, which was previously only available as an injection.

In the United States, about 1 in 13 children have a food allergy, and at least 2 in 5 children have experienced an allergic reaction severe enough to go to the emergency room, according to data from the CDC.

Neffy generated sales of $72.2 million in its first full year on the market. More than 28,000 healthcare providers have prescribed Neffy to date, with approximately half being repeat prescribers, according to the company. Those with commercial insurance can get Neffy for a $0 copay for two packs (four devices).

Within Medicaid, nine states provide unrestricted coverage for patients, including Texas, Illinois, Oklahoma, Colorado, Iowa, North Carolina, Alabama, New Hampshire, and Florida. Most commercial insurers and states with Medicaid coverage that do not automatically cover Neffy do provide access with a prior authorization.

ARS Pharmaceuticals launched a retail cash option for Neffy in May 2026. With a cash price of no more than $199, Neffy is available at local pharmacies, the online pharmacy BlinkRx or getneffy.com.

Additionally, more than 10,000 schools have opted into the neffyinSchools program, with each school receiving two cartons of Neffy 2 mg or 1 mg at no cost for emergency use through the School Health Corp. SHConnect platform. More than 200 successful uses of Neffy have been reported, the company indicated in an investor presentation.

“At ARS Pharma, we are committed to expanding access to neffy for patients at risk of severe allergic reactions and continue to work closely with payers to broaden coverage,” a spokesperson told Managed Healthcare Executive.

Research continues on Neffy. ARS Pharmaceuticals is conducting a phase 2b trial with a low dose of Neffy in patients with acute flares of chronic spontaneous urticaria (CSU), a condition that causes hives and tissue swelling. There are about 1.5 million patients who have been diagnosed and treated in the United States, and about 900,000 of these patients are uncontrolled. No treatment is currently available for acute CSU flares.

Interim results from the CSU trial will be released in the fourth quarter of 2026. A single phase 3 pivotal efficacy study in mid-2027.