The Cost Of A Life-Saving EpiPen Has Increased 400% Since 2007

From Consumerist / August 19, 2016 / By Laura Northrup

If you or someone in your family has severe allergies, the EpiPen is a familiar and essential product. Yet if you have good health insurance, what you may not know is that the cost of the pens has increased significantly since pharmaceutical giant Mylan acquired the drug in 2007.

Different sources list different prices, but the cash price for an EpiPen has increased somewhere between 400% and 600% in the last decade since Mylan acquired the product. A pack of two pens can cost hundreds of dollars at retail.

According to reporting in Bloomberg BusinessWeek from last year (warning: auto-play video at that link), Merck got rid of the EpiPen, which wasn’t a big money-maker at the time, by selling it to Mylan. The auto-injector pen contains about a $1 dose of the drug epinepherine, yet somehow costs 400% more on the wholesale market, and the cost to insurance companies and patients forced to pay retail has probably increased even more.

While the EpiPen is a 25-year-old device, there is no direct generic equivalent. One important money-making strategy for Mylan has been to hand out free pens to familiarize people with the product. The company has also been working to make sure that the pens end up purchased in bulk for schools and in other public places for allergic emergencies…just like the automated defibrillators that are now easy to find. Mylan has even worked with the same consultants as defibrillator-maker Medtronic.

Well, okay, but what can patients actually do about those high prices? For lower-income patients whose insurance doesn’t cover the devices, there’s a patient assistance program, and the company also offers coupons that bring the co-pay down if your insurance does cover the device.

You can also opt out of using Mylan’s product altogether. Dosing your own epinepherine in a syringe isn’t recommended, but there’s another auto-injector on the market that costs less than an EpiPen. Since it isn’t a generic, you can’t just receive one at the pharmacy when your doctor has prescribed EpiPens.

When our colleagues down the hall at Consumer Reports checked prices for the device, they found that the Adrenaclick cost less than half as much as the EpiPen. Another alternative product, Auvi-Q, was recalled and taken off the market earlier this year.

Check with your insurance company, but all of these products should be covered: it’s just that the ubiquity of the EpiPen makes it the first product that doctors and patients both think of. It’s the Kleenex or Band-Aid of lifesaving injector devices.

What’s important is to make sure that everyone knows how to use the alternative device, if your doctor agrees that one of : the allergic person and other household members should know how to administer the drug.

For children, make sure that parents and other caregivers, as well as staff and nurses at the school know that the device is an Adrenaclick and not the more familiar brand.

Though that may not help much either: one parent who spoke to MarketWatch said that her high-deductible health plan means that a two-pack of EpiPens costs $500 with a discount coupon from Mylan, while a two-pack of the Adrenaclick cost $400.

https://consumerist.com/2016/08/19/the-cost-of-a-life-saving-epipen-has-increased-400-since-2007/

Prescription Price Sticker Shock Is Now A Common Consumer Ailment

By Laura Northrup August 13, 2015

Maybe this has happened to you: you’re at the pharmacy, picking up a refill of a prescription that you or a family member have been taking for a long time. It’s a routine errand until you get sticker shock: the copay has suddenly shot up. You didn’t change insurance, it’s still the same year, and the drug is the same: how can a price change so dramatically so quickly?

Our colleagues down the hall at Consumer Reports heard about this phenomenon and investigated how widespread the problem is, and how to deal with sudden drug price spikes. They learned that drug prices have been rising dramatically in the last few years, especially for generics. Insurance plans normally place drugs on tiers according to how much they cost or simply don’t include them on the list of covered drugs (the “formulary”) at all, as CVS/Caremark recently did with Viagra and some other pricey brand-name medications.

An old, inexpensive drug that has been on the market for decades might be Tier I and have a very low copay or even none at all. More expensive drugs might be on higher tiers or not on the formulary at all. What’s been happening recently is that a drug will sometimes increase in price significantly with no warning.

“For whatever reason, raw material shortage or some other problem, literally overnight we’ll see a dramatic increase,” an independent pharmacist in Texas told Consumer Reports. Pharmacies pass the sudden cost increases on to their customers and to their insurance companies. Some generic drug prices have increased dramatically, like tetracycline, which increased from five cents per pill to $8.59 per pill in just a year.

Consumer Reports recently polled adults who take prescription drugs to find out whether this had happened to them. One-third of respondents said that it had. Most of them (81%) simply paid the higher price at the pharmacy because, well, they needed the refills. Some paid more than $100 per prescription out-of-pocket.

One example: a woman who doesn’t have insurance had to pay $500 for a three-month supply of hydroxychloroquine, a venerable drug for rheumatoid arthritis that used to cost about half that much. She didn’t have a choice, though, and paid the higher price.

After leaving the pharmacy, most people in the poll tried to manage the issue, contacting their insurance company to make sure there was no error, and checking with their health care provider to find out whether cheaper alternatives were available. For many people, a sudden spike in the cost of important medication means skipping payments on other bills or avoiding other medical care.

If this happens to you or to someone in your family, what can you do?

Review your medications: you may be able to drop or change some maintenance medications.

Check the formulary: It should be available on your health insurer’s website, and lists covered drugs and lower-cost alternatives.

Shop around: Check prices between different pharmacies and big-box stores. Some offer cheap generics that other chains don’t, or offer some categories of drugs with no copay as a loss leader to attract new pharmacy customers. Costco fills prescriptions for non-members, and you might find assistance or the lowest price in an unexpected place.

Are you paying more for your meds? [Consumer Reports]