Why are EpiPens so expensive?

epipensEpiPens – lifesaving but costly

I’m allergic to bee stings, so I keep an EpiPen handy when I’m working out in my garden this time of year.

But my EpiPens are more than 3 years old now, and it’s time to invest in a new set.

Why do I say invest? Because EpiPens are incredibly expensive!

Related post: First aid for bee stings

I didn’t know that three years ago when I bought them. At that time, my health insurance did not include coverage for prescription medications (all ACA-compliant plans must now), so I paid the full price out of pocket.

I thought the pharmacist had made a mistake when I looked at the charge—$349! How could that be right? Epinephrine has been around forever; it’s as ordinary as aspirin, for heaven’s sake!

“Three hundred and forty nine dollars?” I asked the tech. “Is that right?”

The poor man looked beleaguered. I’m sure I wasn’t the only customer who’d squawked about the price. He just shrugged sympathetically and said, “Well, there are two pens in the package.” (In an allergic emergency, one pen is sometimes not enough, so now EpiPens are only sold in a twin pack.)

That price for EpiPens was three years ago. I just looked up the current cash price at the same pharmacy on GoodRx: $637.33. Yikes. And that’s with GoodRx’s discount coupon.

Why so expensive?

First, although epinephrine is cheap, it’s the method of delivery—the single-use, auto-injector—that is so expensive.

And that’s maddening because it was developed by the US military—with taxpayer money—for use on the battlefield.

Second, it’s a case of supply and demand. In the last decade, there has been a steady increase in the number of children with severe allergies. Because of this, most schools and day cares are now required to have EpiPens available on site.

Families are often stuck buying two sets of EpiPens, one for home and one for school. Or even more, if they have more than one child with a life-threatening allergy.

Related post: Kids and allergies

Third, pharmaceutical companies these days are massively increasing the price of all drugs, even generics. Why? Basically because they can. (For perspective, an EpiPen in 1986 cost just $35.59).

Drug pricing is one of the driving forces behind rising healthcare costs, and it’s a subject of much debate in the healthcare industry and Congress.

How to save money on EpiPens

EpiPens have an expiration date of 12 to 18 months. Mine are over three years old, so I do need to get new ones. I have no idea how much it will cost me, and I’m trying to do a little research and know my options to find the best price.

1. Know your insurance benefits

My bronze plan doesn’t have a prescription drug copay. I have to pay full price until my deductible ($6,350) is met.

Other plans have a brand-name co-pay that is anywhere from $0 to $100, depending on the plan. Generic co-pays are usually much less, in the $0 to $25 range. Know your co-pay!

Talk to a customer service rep at your insurance company to get help navigating your prescription drug benefits. My company offers a case manager who could help me find the best price or give me information about drug assistance programs.

2. Compare prices

Use an online price comparison tool such as GoodRx to see how much different pharmacies in your area are charging for EpiPens.

No doubt EpiPens have the most name recognition, but there is another brand-name auto-injector on the market: Adrenaclick. At my pharmacy, it’s priced at $484.93.

Not much of a savings, but some.

Until recently there was a third brand, Auvi-Qbut they were forced to issue a total recall of the product a few  months ago because of a manufacturing problem. Last I heard the company, Sanofi, isn’t going to continuing making the Auvi-Q injectors.

3. Opt for the generic version

It’s not well known, but the makers of Adrenaclick do offer a generic version of their product. It’s so generic it doesn’t even have a name!

It’s tricky to get the generic version and there is a lot of confusion because doctors cannot just check the “OK to substitute a generic” box on the prescription, like they can with most other medications. The FDA doesn’t consider these auto-injector devices to be therapeutically equivalent, so won’t allow substitutions. If you want the generic, your doctor has to specifically write the prescription for it.

But as I mentioned before, even generics can be costly.

According to GoodRx, the cost of the generic Adrenaclick is $379.76, with the discount coupon. Woo.

4. Use a drug assistance program

Mylan, who markets the EpiPen, offers a $100 co-pay discount card for patients WITH insurance. It basically covers the first $100 out-of-pocket cost.

Patients without insurance are encouraged to apply to the Rx Patient Assistance Program. Help is based on financial need; patients with income less than 200% of federal poverty level may be eligible for EpiPens at no cost. (Lots of paperwork involved!)

Taking all this information into account, I’m guessing a 2-pack of generic EpiPens will end up costing me about $300 – $350, just like last time.

For more information, check out the list of online drug price compare tools on my Resources page. These sites offer discount coupons, links to relevant patient-assistance programs and other tips to save money on all prescriptions medications.

Sláinte,

Frugal Nurse

Image “EpiPen Auto Injector” by Greg Friese is licensed under CC BY 2.0

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Comments

Why are EpiPens so expensive? — 16 Comments

  1. I think people should be wondering why people are being born with these allergies that is staggering to think of. the chemicals we are exposed to are everywhere on everything and there really isn’t any focus on that.

  2. wah wah wah.

    nothing is for free. everyone has to pay bills
    I do not want to pay for your medications

    • Let me pop your bubble. First off, you are already paying for it. You can thank the Obama administration for that. Secondly, there is ZERO reason epipens need be that expensive. It’s literally corporate greed and nothing else. The lady that runs the main epipen company is pulling a yearly salary of around 17 MILLION. The bitch intentionally raised the price of epipens. When she did, her salary went to what I said, up from only 2 million.

    • I hope that someday you have a life threatening disease that requires a medication that you can’t afford. Tough titty huh……wah wah wah

  3. Same frustration on our end- it’s nice to see that we are not alone. We’ll never meet our deductible year after year so the EpiPen payment is around $600 every time. I don’t understand the reason this is not considered a preventative drug compared to others on that list.

    • Hi Stephen, it is frustrating, isn’t it? And it just blows my mind that Mylen is allowed to charge that much for their product. I’m all for drug companies making a reasonable profit, but $600+ for a few cent’s worth of epinephrine? I could rant about that all day!

      I just filled my prescription and, interestingly, I was able to get a MUCH cheaper generic version that I didn’t even know existed. The EpiPen was going to cost over $600 (w/out my insurance it would have been over $700), so I asked the pharmacist about having my physician write a prescription for the Adrenaclick, and how much would that cost. She did a little research in her computer and told me she could give me a generic EpiPen (NOT Adrenaclick) and it would only cost $100! Without my insurance it would have cost over $500, so obviously my insurance company’s pharmacy benefits manager (PBM) prefers this over the brand EpiPen. I don’t know if this information will help you, but talk to your insurance company or PBM or pharmacist and ask if they cover this generic EpiPen. It’s by Lineage Therapeutics, and it’s simply an auto-inject 0.3mg epinephrine (2 per box).

      I just lucked into this by asking questions, but it saved me a lot of money! Cheers, FN

      • I got the Lineage therapeutics last year (April 2015) my pharmacy (Walmart in Toledo Oh suburb) automatically gave that one to me for the $4 co pay. They told me the generic version was just released a few weeks before I got mine. Those pharmaceutical companies are sticking it to us for sure.

      • The question is, why does the FDA and/or US government allow this?

        I think it is high time to revisit patent and regulation laws. It seems that non-original ideas/works are being patented

        Albuterol, for example, used to be $25. Now it is $80 because the CFC on these medical devices were banned. Ventolin, for example, costs $10 in the Philippines. If GSK can charge as low as $10 over there (locally manufactured though), why can’t they charge it approximately or similar in the US?

        Why is it that the government is overegulating entry of competitors?

        Why can’t we just import the $10 Ventolin from the Philippines? (Still manufactured by GSK!)

  4. I had to replace my EpiPens and believe it or not the cost before insurance kicked in was $750.00. Because of my deductible I had to pay $613.00!!! No one told me about Mylen offering $100 off but I did finally get approved and the pharmacist deducted the $100. Good luck to all who need this life saving product finding it at a lesser cost than I did.

    • Oh, I believe it! Hi Leslie, thanks for commenting. Like you, I have a huge deductible to meet first, so I know when I replace my EpiPens it’s going to be super expensive. That’s why I have 3-year-old EpiPens in my medicine cabinet. Not the best idea, but I can’t afford the out-of-pocket costs. I really hate that our lives seem controlled by our health insurance benefits! Best, FN

  5. the $0 copay coupons are really the same as the $100 off coupon. The $0 coupon will take up to $100 off. If you need 2 sets (4 devices) and the cost is high, just pick up 1 set, use the $100 off coupon, and go back in a few weeks to get the other set and use the coupon again. That way, you save $200 instead of $100

  6. I have been getting EpiPens for my son (peanut allergy) for several years. When we had a better insurance plan, it was only around $60-something for a set. Now, of course, it’s over $300 for the same product. My pharmacist is wonderful, and always tries to help save money. She gave me Mylan’s EpiPen $0 co-pay card, so I got my latest set for free. I had to fill out my name/address, etc, so I assume this is a one-time deal. (I just have a regular old high-deductible private health insurance plan). My pharmacist also told me she sometimes gets savings cards for $100 off EpiPen sets.

    My son also gets allergy shots, and at our particular clinic these days, anyone getting an allergy shot has to have an EpiPen (even if they’re just getting shots for run-of-the-mill seasonal allergies). So there’s a really high demand for them now.

    When anyone buys an EpiPen, they should ensure they’re getting a product with the farthest-away expiration date. Our pharmacist had EpiPens expiring in 8 months, and some expiring in a year, so of course we asked for the ones expiring the latest.

    • Hi Sarah, thanks for sharing your experience. It’s great you have a pharmacist who was willing to help you. And you brought up an important point about the shelf life of EpiPens, which is 18 months after date of manufacture. Pharmacies will sell what they have available, and the sell-by date could be less than a year. Always check! I know I will, so thanks for the tip. Cheers, FN