The Neffy could pave the way for Canada's future in allergy care

This episode of The Big Story explores the recent approval of NEFI, a nasal spray version of epinephrine, by Health Canada—a breakthrough that could transform allergy care in Canada. Host Maria Kastane speaks with Dr. Mariam Hanna, a pediatric allergist and clinical immunologist, about the rising prevalence of anaphylaxis across all age groups, particularly the growing number of adults developing new-onset food, medication, and venom allergies. The discussion highlights the limitations of current treatment options, the psychological and logistical barriers to using EpiPens, and the importance of shifting from a 'diagnose and adios' model to lifelong patient empowerment. Dr. Hanna emphasizes the need for better transition support from pediatric to adult care, self-advocacy, and updated guidelines. The NEFI nasal spray offers a needle-free, fast-acting alternative that’s already in use in the U.S., with potential to increase access and reduce fear around emergency treatment. The episode also touches on emerging therapies like oral, sublingual, and epicutaneous immunotherapies, as well as the role of biologics in blocking allergic reactions. Despite progress, challenges remain around cost, access, and national policy coordination, with advocates pushing for a unified national anaphylaxis action plan. Key takeaways include: 1) The NEFI nasal spray is a game-changing, needle-free epinephrine option that could improve emergency response rates; 2) Adults with allergies often fall through the cracks after transitioning from pediatric care—self-advocacy and ongoing medical follow-up are critical; 3) New treatments like immunotherapies and biologics are expanding options beyond avoidance and epinephrine; 4) Public awareness and policy changes are needed to ensure epinephrine is available in workplaces, schools, and public spaces; 5) The approval of NEFI reflects a broader shift toward patient-centered, accessible allergy care. The episode ends with a call to action for listeners to share their experiences and help drive systemic change.