FARGO — A less costly alternative to the EpiPen for severe allergic reactions — a treatment that can cost $400 to $800 per dose — is now available for North Dakota ambulance services.

The North Dakota Department of Health is launching a training initiative that will enable emergency medical responders and emergency medical technicians to deliver epinephrine-adrenaline in injectable form, which is much less costly than the EpiPen auto-injector.

“We’re trying to provide an option,” Chris Price, the emergency medical systems director for the health department, said Wednesday, Nov. 28.

Through a grant program, the state already helps ambulance services purchase the auto-injectors, used to treat life-threatening allergic reactions, he said.

The EpiPens have a shelf life of up to two years, so ambulance services that recently stocked the items might not need the training until later, Price said. “Most ambulances have this already in stock,” he said.

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Kristi Engelstad, a paramedic for F-M Ambulance Service who trains rural ambulance teams, welcomed the new training program, which uses needles and syringes rather than EpiPen auto-injectors. She said it will provide significant help to rural emergency medical providers.

“It’s needed, and it’s going to be a huge cost savings,” she said. “It’s huge for these squads.”

F-M Ambulance staffs its ambulances with paramedics, who are licensed to provide epinephrine using a needle and syringe. But most smaller ambulance services, especially those in rural areas, must rely on emergency medical responders and emergency medical technicians, she said.

Not carrying EpiPens or the injectable equivalent is not an option for any ambulance service, Engelstad said.

“They have to have it,” she said. “It’s a lifesaving drug.”

Once trained and certified, the emergency medical responders and technicians can immediately administer the injectable allergy treatments, Price said. Recertification of the skill will be required every two years.

Besides the cost savings, there have been EpiPen shortages as recently as May, so the enhanced skills also will help to ensure ambulance services have adequate supplies of the drug, he said.

“We wanted to make sure it’s readily available,” Price said.

F-M Ambulance is ready to provide the training when asked to do so by ambulance services in surrounding towns that they work with, Engelstad said. Minnesota already has a similar training program.

“It’s ready to go,” she said. “It’s just when they want us to come out.”

Emergency responders can obtain course registration forms on the Emergency Medical Systems page of the ndhealth.gov website.