EpiPen price increase sparks concern for allergy sufferers

A steep increase in the price of the EpiPen, a lifesaving injection device for people with severe allergies, has caused outrage among consumers and lawmakers who worry that parents will not be able to afford the pens for children heading back to school.

With a quick stab to the thigh, the EpiPen dispenses epinephrine, a drug that reverses swelling, closing of the airways and other symptoms of a severe reaction to bee stings, peanuts or other allergens.

Mylan, the pharmaceutical company, acquired the decades-old product in 2007, when pharmacies paid less than $100 for a two-pen set, and has since been steadily raising the wholesale price. In 2009, a pharmacy paid $103.50 for a set. By July 2013 the price was up to $264.50, and it rose 75 percent to $461 by last May. This May the price spiked again to $608.61, according to data provided by the Elsevier Clinical Solutions' Gold Standard Drug Database.

[Commentary: How health care costs are bleeding Alaska dry]

Doctors advise allergic patients to carry two EpiPens with them at all times in case an extra dose is needed to quell a severe reaction. Most parents buy multiple EpiPens for home, in the car and school and may replace them annually, depending on the expiration date, which is typically 12 to 18 months after purchase.

Mylan has declined to comment on the price increase, issuing a statement pointing to high-deductible health plans that require consumers to pay much more out of pocket for many drugs. The company said a $100 coupon it offered for the product meant that most people do not pay anything for the pens.

But how the price increase affects consumers varies widely, depending on the prices charged by their local pharmacies and the details of their insurance plans. People without insurance or with high-deductible insurance plans cannot always use the coupon and are paying about $640 a set, said Michael Rea, the chief executive of Rx Savings Solutions in Overland Park, Kansas. Other patients say that even with good insurance, their copayments are as much as four times higher than in the past.

Naomi Shulman of Northampton, Massachusetts, has a 12-year-old daughter who is allergic to cashews and keeps EpiPens at home and school. Last year, Shulman's out-of-pocket copay for an EpiPen two-pack was $100. But because her EpiPens expired after one year, Shulman had to buy another two-pack to send along to her daughter's camp this summer. Her cost for the same two pens was $400.

"I called the insurance company and asked why it was so high and was told that, actually, it's $700 total, and my copay is $400," she said.

For the first time in 10 years, Shulman said, she briefly considered forgoing the purchase, but did not want to risk it. "It's very wrong," she said. "It's gouging parents about their children's lives. It's not like letting them sniffle. It's life or death."

Laurent Barr of Clark, New Jersey, said that her copay on EpiPens has risen from $141 to $245 in a year, and that she will spend $735 this year for a supply of three EpiPen sets. Her 6-year-old daughter, Leah, is allergic to rice, tree nuts and mushrooms.

"The price of EpiPens has been getting progressively worse over the years, but now it is just obscene," Barr said.

The price increase has caught the attention of Washington lawmakers. Sen. Amy Klobuchar, D-Minn., who has a daughter who carries an EpiPen, has called on the Senate Judiciary Committee and the Federal Trade Commission to review whether the price increase violate any anti-competition rules. Last year, the drugmaker Sanofi recalled a competing product, Auvi-Q, because it might not have been delivering the correct amount of epinephrine, leaving the EpiPen as the primary emergency treatment for severe allergic reactions.

"This is a mainstream product that people carry, and it's getting harder and harder for people to afford it," Klobuchar said. "It's just another example of what we keep seeing, outrageous price increases when a monopoly situation ends up in a company's lap."

Sen. Charles E. Grassley, R-Iowa, called on Mylan to explain the price increases, noting that they impose a burden on both parents and school districts, who often keep supplies of the pen at the ready.

A petition to Congress protesting the price increase, called "Stop the EpiPen Price Gouging," has emerged on social media. It has collected more than 49,000 signatures.