EpiPen safety
Health Topics

EpiPen primer: what to know about access


August 25, 2016

As prices for the life-saving device skyrocket, here’s why the EpiPen is important and what parents can do.


People with life-threatening allergies know the mantra: Keep an EpiPen with you.

The popular epinephrine auto-injecting syringes have become routinely recommended, serving as crucial pieces of the treatment plan for severe allergic reactions, halting anaphylaxis and preventing death.

The spiraling cost of the EpiPen is making headlines while also affecting patients’ ability to access it. And that is an ongoing struggle, not a one-time barrier: Patients must get a new device about every year because the drug expires. EpiPens are sold in twin packs, but they should be kept together in one location because a second dose is often needed to stop a serious allergic reaction.

“Some patients have cited the cost of an EpiPen set as more than $700. Most have objected, but then paid because this is a life-saving drug for them or their child,” said Donna S. Hummell, M.D., Medical Director of the Vanderbilt Asthma, Sinus and Allergy Program and Clinical Director of Pediatric Allergy at Vanderbilt.

“Only one parent of a child said that they paid out of pocket willingly so that they could meet their insurance deductible for the year. Many have tried to use coupons for savings, but those only reduce the cost modestly, and most patients have told us they were still paying at least $500-$600.”

Advocacy organization Food Allergy Research and Education recommends several methods of assistance, including exploring patient assistance programs, using manufacturers coupons, shopping around for the best prices and more.

What sets the EpiPen apart?

The cost of the EpiPen has skyrocketed since 2009, though the increases were more masked until insurance deductibles began climbing. People now are paying more out of pocket. A New York Times story reported that in 2007, pharmacies paid less than $100 for a set of two EpiPens, but by May 2016, that price had spiked to $608.61.

Hummell said Vanderbilt University Medical Center’s pharmacy has notified her staff of an alternative epinephrine autoinjector. The drawbacks: It still costs $400, it is not available in a pediatric dose and a major commercial retail pharmacy does not carry it.

Underscoring the EpiPen’s importance is the fact that the possible alternative of prescribing epinephrine in a vial with separate syringes is fraught with risks. Would the person having the reaction – or the person helping — be able to use the syringe and access the medication in the vial properly? Would he or she know how to measure the correct amount to deliver? How long would that take? Would the person know how to inject properly and into the correct part of the body?

“Add to this that most will be self-injecting and in a dire circumstance when the patient may lose consciousness before they are successful, and one can see that this is not a viable alternative,” Hummell said.

EpiPen’s maker, Mylan pharmaceuticals, emphasizes the co-payment coupons it offers and its donations of EpiPens to qualifying schools through the EpiPen 4 Schools program. Hummell knows of no such program for adults.

As a group of U.S. lawmakers is pushing for an investigation on the soaring costs, Hummell said, “Patients need to speak up and lobby their congressional representatives, join the Food Allergy Research and Education organization and other patient support organizations, to increase the impact of their voice in this matter and in others affecting the health and well-being of themselves and their children.”

Read FARE’s statement and learn more about assistance resources here.

Vanderbilt Asthma, Sinus and Allergy Program is offers total care for asthma, allergy or sinus problems, including testing, treatment, resolution and management. Call (615) 936-2727 for an appointment.