If you or your family member has serious, life threatening allergic reactions, called anaphylaxis, then you are very familiar with the image above.  For everyone else, this is an EpiPen which contains a dose of a medication called epinephrine that can be lifesaving in an allergic reaction.  EpiPen has been manufactured by the Mylan company since 2007.  For those that have severe allergies, they are instructed to carry these pens with them 24-7, 365 days per year, and this is especially true for children while they are in school.  Those that have these pens at home are likely also acutely aware of the absolutely shameful price gouging that Mylan has done with EpiPens in the past 9 years.  Wondering how this could happen? Yeah…so am I.

These EpiPens come as what are called a “twin pack” meaning that one prescription will get you two of these pens.  The reason that is so important is that sometimes, in life-threatening situations, one dose of epinephrine is not enough.  Back in 2007, a twin pack cost around $94.  Some may even be surprised by that cost knowing that it is a prescription that expires every year and that it is a medication you must get but hope to never use.  Want to know the current cost of an EpiPen? How about just above $600?! That is an increase of over 400%.  Insurance you say? That $600 price tag is the cost that many families are forced to pay given the higher deductible plans that are in the insurance marketplace these days.  Shocked? Angry for those that MUST have this medication? Yeah…me too.

So perhaps that only thing more stunning and appalling than the actual cost of this medication is the $16 million dollar raise the CEO of Mylan has received over the same time period that this price hike has occurred.  That’s right…the CEO makes a whopping $18 million dollars per year.  I listened to an interview with the CEO, Heather Bresch, from earlier today, and at times my blood was boiling. She said, “As a mother, I can assure you the last thing we would ever want is someone to not have their EpiPen due to price.”  She went on to say that it was never intended that patients would pay this outrageous price as insurances should have covered the cost. Instead, she blamed our current healthcare system saying that patients are paying higher cost for insurance that is not providing the coverage for the higher cost of medications.  While this is certainly a politically charged issue that does involve more than just an EpiPen, we have a CEO who has had a 671% increase in her salary over the past 9 years saying the cost of her product is out of her hands.  Are you buying that one? Yeah…me neither.

Mylan came out today saying that they would be offering increased rebate cards which would decrease the cost of the EpiPen by as much as $300.  Reading the fine print though, these rebate cards are only for those with commercial insurance.  For those families with high deductible pharmacy plans, they still may have to pay close to $300.  If you have medicaid or medicare, there will be no change in the cost of your EpiPen as these rebate programs do not apply to you.  Finally, for those that are uninsured, a family can apply yearly to get their EpiPen free of charge if they make less than 400% of the poverty level (this equates to just over $97,000 per year for a family of 4).

Some may wonder if there are any other products available on the market to compete with EpiPen, after all, competition is a good thing in the consumer marketplace.  Well, there was a product called Auvi-Q which provided the exact same epinephrine medication through a device that actually talked you through giving the injection.  However, this product was recalled late last year because of concerns for inaccurate dosing of medications.  The only other product available is called Adrenaclick or epinephrine auto-injector which can typically be found for closer to $100.  This option is something you should discuss with your physician or allergist as you will need to understand how administering with this device is different than an EpiPen (the pen itself looks different, the needle is exposed after the injection is given, etc).  If you would like to learn more about epinephrine auto-injectors, you can click here.

It is my hope that with all of outrage and fervour surrounding Mylan, its CEO, and the astronomical cost of EpiPen, there will be changes that can occur.  I am not naive to think that this problem solely exists with the EpiPen, and it is clear that our healthcare system as it stands today is likely contributing to these atrocities.  I do not have quick or easy answers for how to “fix” healthcare, but what I do know, is that a family should not have to choose between having an unexpired EpiPen for their child vs holding their breath and praying that they never need this life-saving intervention.