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.
So, the provided link did not pan out. The Walmart cost for 2 pens from another maker was $588, nearly identical to EpiPen prices. The discount coupon - not so much. But as a result of the conversations with Walmart pharmacists, an alternative pen was found and approved by the allergist and resulted in a $20 co-pay per 2 pens!! One happy grandma!
I am, however, still angry about the exorbitant costs quoted (and paid by folks who don't know how to or can't pursue alternatives) and the lack of information provided to my daughter by pharmacists, MD & insurance company.
Thanks to everyone who provided assistance. Love this forum!
I get the epipen JR for my daughter and they are expensive but I only pay $150 for 4 per year which in my opinion is worth the money for peace of mind.
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.
So sorry your family has to go through this. I agree that our health care delivery system is out of whack. Now that we made a few strides as far as insurance is concerned, ie. getting rid of pre-existing conditions exclusions etc...It seems that the Pharma issue has gone crazy!!! I hear these kind of stories all the time. People being taken advantage of...so sorry.
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.
Yes, this is fine for professionals who know how to accurately draw up the med. What about the day care worker or lay person parent or adult patient themselves? what are they supposed to do?
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?
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.
Good points! Now that I think about this, I had some errors occur before as well. This does seem crazy that insurance pays roughly only $2 towards cost...
Yes, this is fine for professionals who know how to accurately draw up the med. What about the day care worker or lay person parent or adult patient themselves? what are they supposed to do?
So wrong on so many levels.
Thousands of insulin dependent diabetics, even children, do it everyday.
EpiPens are important but in reality the alternative is the daily ritual for thousands of others.
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 cant believe how much criticism you have gotten. What is wrong with people?
I get the point of researching the possibility that is could last longer....But who wants to take that chance with their Grand daughter's life? As if that is a "logical" action.
Good points! Now that I think about this, I had some errors occur before as well. This does seem crazy that insurance pays roughly only $2 towards cost...
Well...while convenient, auto-injectors are not the only way to delivery an injection.
If you had the expert testimony to conclude that your epi pen would indeed be good for that length of time AND you knew the storage was ideal, there wouldn't be anything to feel bad about. You did your due diligence. You might second guess, but if you did, you wouldn't be the type of thinker who would keep an epi pen past the expiry for logical reasons; you would be the type of person who would keep an epi pen past the expiry to save money. There is a right away to confidently keep an epi pen past expiry and a wrong way. Storage is the big issue. Testimony on the length the pen is useful for is the other big issue. With both, you have a strong argument to keep the pen past expiry. With the absence of either, the argument isn't valid.
This falls into more of a business situation that is harder to avoid. I would expect that an epi pen stored at a school is being stored properly, but despite that, the bureaucracy is going to force you to shell out the money regardless. This is more of a business situation than a personal situation.
Okay, but does that make it right? No, of course not and anyone who has lived longer than 5 minutes knows that life is not fair. The point is that here is another situation where "business" rules over and makes impossible for some, to get the medical care they need and PAY for. How is it legal for (I know it is, just don't know why...), for businesses related to something like a child's health or anyone's health for that matter is allowed to gouge for profit? I'm not saying "keep their business head above water", I mean GOUGE the people for whom their business serves? Billions in profits? Really?
I had an EpiPen several years ago because I had had allergic reactions to bee stings. I never had to pay that much for an EpiPen ! Later I was tested at a medical center and was told I was immune to bee stings.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
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.
I know I am going off on a tangent, but perhaps these arcane rules partially explain the explosion in the popularity of homeschooling over the past couple of decades.
roser13, ASN, RN
6,504 Posts
Well, apparently not mine.