Lisa Deck buys EpiPens for her two sons, ages 2 and 4, who have severe food allergies.
The devices, known as epinephrine auto-injectors, can mean the difference between life and death for 1 in 50 Americans who suffer from anaphylactic reactions. Auto-injectors deliver a one-time dose of epinephrine, also known as adrenaline. The drug opens up a person's airways, reduces swelling and stabilizes blood pressure.
“It's not a choice; I need them,” Deck said about paying $440 for each carton of the devices this year under her high-deductible healthcare plan. The average price for one injector in 1986 was just under $36.
Experts say regulatory challenges and the liability drugmakers could face if just one device fails are hurdles to creating a competitive market.
That means patients and parents of children who could suffer from anaphylactic shock and account for the highest percentage of prescriptions face high costs and frustrating realities.
Deck, who likes her high-deductible plan because it helps her control medical costs, has a sister who gets EpiPens with no copayment.
Mylan's name-brand EpiPen—which comes in a two-injector pack because patients sometimes need a second dose—costs consumers about $535 when purchased under two major insurance plans, before a $100 coupon, according to sample data from Oration, a software company that helps companies and their employees reduce prescription costs. Out of pocket, the device can cost as much as $574 with the discount.
Customers often buy multiple devices to have at school or work, and the devices expire, which means they must be replaced every year, even if they're unused. Some studies have suggested that the yearlong shelf life approved by the manufacturer and the Food and Drug Administration may be conservative.