Public backlash over EpiPen price spikes may have affected the company's market share among some prescribers, according to a new report.
Although EpiPens still make up the overwhelming majority of prescriptions for epinephrine auto-injectors, other brands are becoming increasingly popular with providers, according to data from EHR vendor Athenahealth. The share of Epineprine auto-injector prescriptions that were not EpiPen was 7.9% in September, up over three percentage points from August, when widespread EpiPen concerns began to take shape.
Athenahealth's data, which is recorded from over 970 providers using the EHR, showed that the EpiPen, which is made by Mylan Pharmaceuticals, still has a roughly 92% market share. And public backlash against Mylan doesn't appear to have stymied prescribing volume among Athenahealth providers, which prescribed 26% more EpiPens in September and August – the busy back-to-school season – than last year.
Non-EpiPen prescription orders are simply classified as “epinephrine auto-injectors,” and could include Adrenaclick, made by Horsham, Pa.-based Amedra Pharmaceuticals, or the generic version of Adrenaclick made by from Lineage Therapeutics, a sister company. It appears as though the non-EpiPen injectors have a cash price of somewhere between $400-$500, depending on the retailer, and there's a $100-off coupon available with a limit of three two-packs.
The data doesn't offer conclusive evidence that customers are choosing EpiPen alternatives due to price, but the change in market share is worth watching, experts said. “The market is receptive to lower cost alternatives, and it will be really interesting to see what happens to them and what happens when additional generics are introduced to the market,” said Josh Gray, Athenahealth's vice president of research.
At the very least, the uptick in prescriptions for non-EpiPen brands suggests that consumers may express interest in EpiPen competitors if they can produce a successful, safe product. Making a product that works every time is an arduous task, and current EpiPen rivals have had trouble breaking through Mylan's strong marketing strategies and common knowledge of how to use the EpiPen rather than other products.
Richmond, Va.-based Kaléo, the initial developer behind the Auvi-Q “talking” auto-injector, announced last week that it would bring the device back to market in 2017. In February, the company terminated its licensing agreement with France-based Sanofi, which recalled Auvi-Q in 2015 for inaccurate dosing and never brought it back to the market.
Israel-based Teva Pharmaceutical Industries has been delayed by over a year in getting Food and Drug Administration approval for its application to make a generic EpiPen. Following the backlash over EpiPen price hikes, Mylan said in late August that it would release its own $300 generic EpiPen in a matter of weeks, but the product doesn't yet appear to be available for purchase.
Dr. Bobby Lanier, a Fort Worth, Texas-based allergist, said he would be willing to prescribe auto-injectors other than the EpiPen, but few patients ask for them. Adrenaclick and its generic version have a slightly different delivery mechanism, but there aren't any extra steps that would make it significant difficult when compared to the EpiPen, said Lanier, who is executive medical director for the American College of Allergy, Asthma, and Immunology.
The alternatives aren't always covered by insurance, but Lanier said he tries to make sure patients at least know they're available. He also said he would once again prescribe Auvi-Q when it is brought back to the market, but cautioned that there's no guarantee that the product will be priced lower than the EpiPen.
“What we depend on in a lot of cases is for pharmacists, ordinarily to drive generic products,” Lanier said, noting that pharmacists have better knowledge of price and sometimes have bigger profit margins for generics.