Consumer outrage over EpiPen's $600 price tag reached a fever pitch yesterday, prompting action from Congress members, including Connecticut Sen. Richard Blumenthal, who issued a letter to its manufacturer, Mylan, demanding that the company lower the price of the life-saving device.
In a separate letter, Iowa Senator Charles Grassley, citing "consumer concerns," asked the company to provide justification for the price increase—more than 400 percent since 2007—by no later than September 6, 2016. And Senators Susan Collins and Claire McCaskill of the Senate Special Aging Committee, in a letter today to Mylan requested an explanation and a briefing on EpiPen pricing within two weeks.
"We are concerned that these drastic price increases could have a serious effect on the health and well-being of every day Americans," the senators wrote. Even the American Medical Association jumped in and released a statement today urging Mylan to lower the cost.
EpiPen is an auto-injector syringe filled with an inexpensive drug called epinephrine. It treats allergic reactions so severe that some people can't breathe, a condition known as anaphylaxis.
Meanwhile, if you're looking for a low-cost alternative to the EpiPen, we recently recommended generic Adrenaclick, also referred to as an "epinephrine auto-injector." Using a GoodRx coupon, you could get it for as low as $140 at Walmart or $205 at Rite-Aid. You might have heard its hard to get, but here's how to procure it.
Ask Your Doctor for an Epinephrine Auto-Injector Prescription
In most states, to get the low-cost, EpiPen alternative, you can't use a prescription for "EpiPen" from your doctor. That's because pharmacists at your drugstore likely won't be able to automatically substitute the low-cost version if your prescription is written for EpiPen. Instead, ask your doctor to write a prescription for an "epinephrine auto-injector" or "generic Adrenaclick."
That's what Adrienne Balkany of Austin, Texas, did after her out-of-pocket cost for EpiPen shot up to $400 two years ago. Balkany carries emergency epinephrine due to a severe allergy to bee stings. Seeking an alternative to EpiPen, she came across a mention of generic Adrenaclick online, and after finding that she'd only have a $60 co-pay after insurance, her doctor eventually switched her prescription to the generic. But doing so required some persistence on her part and several discussions with her doctor, says Balkany. "The hardest part of switching was convincing my doctor to write the prescription because he had never heard of the drug."
Since Mylan purchased EpiPen in 2007, it poured billions of dollars into a robust marketing campaign aimed at making EpiPen a household name. Last year, doctors wrote 3.6 million prescriptions for EpiPen and EpiPen Jr, according to healthcare data company IMS Health—7 percent more than in 2014. Given EpiPen's reputation as the leading treatment for life-threatening anaphylaxis, coupled with last year's recall of its main competitor, Auvi Q, and the otherwise low profile of alternative options, skepticism about non-EpiPen auto-injectors from consumers and doctors alike is not all that surprising. But while EpiPen and generic Adrenaclick are not the same device or delivery system, they both contain the drug epinephrine in the same dosage.
The good news is that pharmacists in more than a dozen states, including California, Colorado, Connecticut, Florida, Vermont, and Washington can fill an EpiPen prescription with generic Adrenaclick—without returning to their physician for a new prescription, according to the drug's manufacturer, Impax Laboratories.
Ask Your Pharmacist to Order the Generic
Because prices can vary from one pharmacy to the next, shop around before filling the prescription. Pharmacies may have a limited supply or might need to order it. A spokesperson from Impax told us that the supply of generic Adrenaclick is "somewhat limited" but that the company is working on increasing the availability. Several stores, including Costco, told us that if the generic auto-injectors weren't currently in stock, they could easily be ordered and would be available for pick up within the next day or two.
"Call the pharmacy before you go to see if it's in stock," advises Victor Curtis, R.Ph., senior vice president of pharmacy at Costco. Otherwise, the pharmacy can order it for next-day pick-up.
A Walgreens spokesperson told us: "Epinephrine auto injector is available in our stores and we have daily replenishment from our wholesaler if product needs to be ordered," which generally arrives the next business day. A CVS spokesperson told us they also stock the low-cost epinephrine auto injector.
If the generic Adrenaclick price is higher than you expected, ask about discounts. A Walmart pharmacy in White Plains, N.Y. told our secret shopper that a two-pack of generic Adrenaclick would cost $606, but when we asked about discounts, they told us they would accept the GoodRx coupon, bringing the out-of-pocket cost down to $140. CVS said it would also accept discounted coupons. The manufacturer offers a co-pay coupon to lower the price if you use your insurance.
A note on safety: If you switch devices, don't wait until you need the Adrenaclick to learn how to use it. Each injector requires a different set of instructions, so people might use it incorrectly during an emergency, says Barbara Young, Pharm.D., of the American Society of Health-System Pharmacists. To prevent that, Young says to make sure you know how to properly use it before leaving the pharmacy—and consider scheduling a training session. As you would with all medications, read your injector's package insert thoroughly. You can also watch a training video on epinephrine autoinjection's website.
