By Kristen Chandler
There has been a lot of uproar recently over the continued price increase for the EpiPen and how it’s becoming increasingly difficult for those who need it to afford it. Since the EpiPen is the auto injector most often prescribed to patients with severe allergies, many aren’t aware of the existing alternatives. Here, I’ll give an overview of those alternatives, as well as Mylan’s plans for a generic EpiPen and the savings options offered by the company.
Auvi-Q: The Auvi-Q injector was once an alternative to the EpiPen; however, it was recalled last year due to inaccurate dosing in some cases. The Auvi-Q’s main appeal was that it provided audio and visual instruction, helping the person administering the injector to do so with ease.
Since being recalled, the rights to the Auvi-Q injector were returned to its developer, Kaleo. At this time, Kaleo is in the process of correcting the issues and preparing to bring the Auvi-Q back on the market. There is no published estimate for when this will happen, but it is something to watch for.
Adrenaclick: The Adrenaclick injector is a lesser-known alternative to the EpiPen. A generic version of Adrenaclick, called Epinephrine auto injector, is also available. The Adrenaclick injector isn’t much less expensive than the EpiPen, however. Even when using a savings coupon found on the Good Rx website, it still costs the patient $450 – $500. That said, you can get a set of the generic injectors for as low as $144.62 by using a savings coupon, again from GoodRx.
Anyone interested in the Adrenaclick or its generic version should discuss these alternatives with their doctor before making a change. Both contain the same drug as the Epipen; however, the devices used to administer the drug are slightly different. Since the EpiPen is not only a medication but also a medical device, another device cannot be substituted for it. The prescribing doctor will need to write the script specifically for the Adrenaclick or the generic. It’s also important to remember that if someone were to switch from the EpiPen to the Adrenaclick or the generic, they would need to be trained on how to use the device BEFORE it’s actually needed.
One downfall of Adrenaclick is that the company isn’t equipped to manufacture large quantities of the device at this time. They are working to produce as many as they can, as quickly as they can.
A Vial of Epinephrine and a Syringe: I know this sounds kind of strange, and possibly a little dangerous, especially when considering this option for children; however, this is one of the cheapest alternatives available. At Fort Hamilton Hospital, Dr. Marcus Romanello has made an epinephrine injection kit using a vial of epinephrine, a syringe and a metal breath freshener tin. This do-it-yourself version costs the patient only around $10.
While this is the cheapest option, all the risks need to be assessed if someone is considering going this route. First of all, the patient would need to talk to their doctor and see if they even agree with this option. The doctor would then need to prescribe a vial of epinephrine and the syringes. The epinephrine vials need to be replaced more often than EpiPens. The patient would then have to be trained to measure the correct dosage and on how to administer it. Anyone else who may need to administer the drug would also have to be trained on proper dosage and syringe usage.
This option has the highest risk of user error. The wrong dose could accidentally be given, the vial of epinephrine could easily break, or a situation might occur where there’s no one close by who knows how to administer the medication this way.
I personally would only use this alternative as a last resort and would probably be the only one to use it for my younger kids. I would make sure my oldest son, who just recently learned and became confident with self-administration, would have at least two pre-measured auto-injectors to carry for himself. But I’m not really comfortable with the idea of him using a syringe. I am also not comfortable with this being the only option that an untrained person would have on hand to treat my child in the event that I was not close by.
Mylan, the distributor of the EpiPen, does offer some discounts. If you visit the EpiPen website, their resources section will direct you to two savings options they have available: the EpiPen Savings Card and their Patient Assistance Program.
The website advertises that, when using the EpiPen Savings Card, “you could be eligible to pay as little as $0” on up to three two-packs of either the EpiPen or EpiPen Jr.
First, patients would have to fill out a form to see if they qualify for the savings card. People without health insurance don’t qualify for the card. And for those who are insured, the savings card covers only up to $300. So, depending on how much the patient’s insurance covers, they’ll still be faced with significant out-of-pocket costs. Furthermore, if the insurance plan includes a high deductible that hasn’t been met, the patient would have to pay the full cost for the EpiPens. Once a deductible has been satisfied if applicable, the patient saves $300 with the savings card, but they would pay the difference, which could be $300 – $400—a savings, yes, but still an outrageous price for a medication that’s critical for so many people.
The Patient Assistance Program is the other option offered by Mylan. As with the savings card, the patient must meet certain requirements. There are insurance and financial guidelines, as well as a form for the patient and prescribing doctor to fill out. Once requirements are met, Mylan ships the medication to the doctor, who gives to the patient for free. The EpiPens are then replenished as needed, providing the doctor fills out an authorization form. The patient must re-apply each year.
Lastly, Mylan recently announced that they have a generic EpiPen in the works. This generic will be identical to the EpiPen at half the cost. It will be available in the 0.15 mg and 0.30 mg strengths just like the EpiPen. Mylan is planning a product launch over the next several weeks.
In addition, the EpiPen website will send you free carrying cases for up to two cartons of EpiPens once you register them. They will also send a free trainer pen upon request. The trainers are on backorder at this time but will again be available in November 2016.
We hope this article has been helpful. If you learned something new here, or if you’ve tried any of the above alternatives or discounts and have had a good or bad experience, we’d love to hear from you in the comments below.