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.

Mylan’s EpiPen price increases are Valeant-like in size, Shkreli-like in approach [MarketWatch]
Can You Get a Cheaper EpiPen? [Consumer Reports]
How Marketing Turned the EpiPen Into a Billion-Dollar Business [BusinessWeek]

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