EpiPens....who knew?

That Guy, BSN, RN, EMT-B · Jun 30, 2016

This is something that is being phased out of EMS as well due to cost. We used to carry epi pens but at $400 a pop to us, it wasn't worth it especially since most of the expired. Changed over to $4 vial and syringe. Saves a lot in the end.

BuckyBadgerRN, ASN, RN · Jun 30, 2016

You truly didn't know this about epi-pens?

roser13, ASN, RN · Jun 30, 2016

You truly didn't know this about epi-pens?

Well, of course I knew about EpiPens. I was clueless as to their cost. Unless you have a family member who uses one, or have dealt with patients trying to purchase one, how would you know the outrageous expense?

nutella, MSN, RN · Jun 30, 2016

So, granddaughter #2 turns out to have some fairly significant food allergies. Daughter goes to purchase prescribed EpiPens. Four of them. You must have 2 in order to give a second dose if EMS is slow to arrive. A daycare situation requires 2 more EpiPens.
Walmart Pharmacy calls to inform daughter that the charge for 4 pens is $1200. Daughter says "oh no, I have Aetna insurance." Pharmacy says "that figure includes Aetna's payment of (drumrolll, please) of $2.62." A discount card found on the internet takes another $200 off. Daughter is left to pay $1,000 for a drug she hopes she will never need and which expires in 10-12 months. One of my OR sources quotes the amount of epinephrine in 1 pen as having the base cost of $.03.
Turns out that the maker of EpiPen has a virtual corner on the market on adrenaline pens. Every year, they increase the price because, well, because they can. They have also been accused of artificially decreasing the expiration date in order to require an annual purchase. Making money hand over fist on the backs of sick babies and adults.
There is so much wrong with our healthcare delivery system.

I wonder if your daughter has a deductible or such for medication/ healthcare.

Folks with high deductible plans often have to pay a certain amount of $$$ before insurance covers.

If this is not the case, she should call the insurance herself to discuss the costs. It happened more than once that the pharmacy made a mistake and tried to charge me $$$ when in fact it was just a copay. In one case, the MD office made a mistake with coding the illness and the led to insurance not covering. Perhaps it is worth for her to call the insurance?

Also, have her check out this page:

What to Do If You Can’t Afford Epinephrine Auto-Injectors | Kids With Food Allergies

perhaps there is some advice she can use.

It should not be $ 1000 out of pocket for 2 packages with each 2 injectors. Even if you pay out of pocket, it is less with coupon.

psu_213, BSN, RN · Jun 30, 2016

Well, of course I knew about EpiPens. I was clueless as to their cost. Unless you have a family member who uses one, or have dealt with patients trying to purchase one, how would you know the outrageous expense?

I would't have known this either...

Going on the way-back machine (OK, like 2 years), maybe this is why the pharmacist did not dispense one to parent whose child was having an anaphylactic reaction... :sniff:

NOADLS · Jun 30, 2016

Do your research on how long these things actually last when stored properly. If your use for them is personal and not business related, you can get away with holding onto an expired one.

Yes the costs are ridiculous, but you don't need to be shelling out money every year like a sheep. You've described a situation where a logical thinker can arrive at a reasonable answer. Sometimes I think I should be charging money for offering logical advice, but I am happy to do it for free hoping that I can inject some common sense into the general population.

RatherBHiking, BSN, RN · Jun 30, 2016

It's becoming like this with a lot meds. I heard in the news about someone wanting to sue someone for marking up cancer drugs so high people can't afford them. It's nothing but greed causing these companies to do this. We're in the same boat with my daughter's inhalers. I can't afford the $500 extra my insurance won't pay. She's living off samples right now.

roser13, ASN, RN · Jun 30, 2016

Do your research on how long these things actually last when stored properly. If your use for them is personal and not business related, you can get away with holding onto an expired one.
Yes the costs are ridiculous, but you don't need to be shelling out money every year like a sheep. You've described a situation where a logical thinker can arrive at a reasonable answer. Sometimes I think I should be charging money for offering logical advice, but I am happy to do it for free hoping that I can inject some common sense into the general population.

I consider myself a logical thinker, but perhaps I'm just a sheep in the world of NOADLS. Please do tell how I can logically come to a reasonable answer to this situation, other than ignoring expiration dates. Because you know, (or maybe you don't), one tends to follow the rules when one's child/grandchild is at risk to life. Ignoring an expiration and thus risking an infant death is not a gamble I care to take.

Hugs & kisses,

Illogical sheep person.

nutella, MSN, RN · Jun 30, 2016

Here is another interesting article

Battle of the EpiPen

and the writer had to pay $$$ because of the high deductible plan....

NOADLS · Jun 30, 2016

I consider myself a logical thinker, but perhaps I'm just a sheep in the world of NOADLS. Please do tell how I can logically come to a reasonable answer to this situation, other than ignoring expiration dates. Because you know, (or maybe you don't), one tends to follow the rules when one's child/grandchild is at risk to life. Ignoring an expiration and thus risking an infant death is not a gamble I care to take.
Hugs & kisses,
Illogical sheep person.

I don't encourage you to outright ignore the expiration date. I do encourage you to do your due diligence with regards to how long a specific epi pen will actually remain effective for. If you have expert testimony that the epi pen you have will last for 2.5 years under proper storage conditions, but the expiry is labeled for one year and you know you've stored the epi pen properly, I think you can safely conclude that your epi pen is good for 2.5 years.

If you are spending so much money on epi pens, you should do your research.

We live in a capitalist country which promotes R&D for these expensive drugs that cost next to nothing to manufacture. You are really paying a premium for the research. I am not saying it is a bad system because without patents and financial incentives, no one would bother with advancing medical research. Knowing how this country functions, the onus shifts onto you to become an informed consumer.

nutella, MSN, RN · Jun 30, 2016

I don't encourage you to outright ignore the expiration date. I do encourage you to do your due diligence with regards to how long a specific epi pen will actually remain effective for. If you have expert testimony that the epi pen you have will last for 2.5 years under proper storage conditions, but the expiry is labeled for one year and you know you've stored the epi pen properly, I think you can safely conclude that your epi pen is good for 2.5 years.

All this does not matter to the school nurse who needs to insist on an epipen that is not expired, otherwise the child will not be allowed in school.

And - what if after 2 years you take the epipen you have at home, because the child is having an allergic reaction and you give both syringes but the child dies (G-d forbid). In that case you would feel terrible guilt for the rest of your life, even if the death was not avoidable with a non expired epipen. There would always be second guessing - did I sacrifice life because of $$?

Properly storage is an issue with epipens. you have to be so careful that they do not get too hot or cold.