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.
Specializes in Complex pedi to LTC/SA & now a manager.
Beachynurse was responding to Dianah's story about her experience and to keeping Benadryl on her at all times. But histamine blockers do not work on anaphylaxis. That's what I was responding to when I made my comment.
I carry all 3. Not all my reactions are anaphylactic. Not all hives are anaphylactic. But the average person should not be making that decision. I know the difference for me. But I see exactly zero point in waiting for epi especially since often a second dose is needed to fully suppress the reaction.
I remember when the two packs first came out and the insurance companies balked at paying for 2 vs 1 EpiPens.
Didn't anakits have a syringe of epi and a couple Benadryl to treat the possibility of two types of reaction? Off to research.
I carry all 3. Not all my reactions are anaphylactic. Not all hives are anaphylactic. But the average person should not be making that decision. I know the difference for me. But I see exactly zero point in waiting for epi especially since often a second dose is needed to fully suppress the reaction.
I remember when the two packs first came out and the insurance companies balked at paying for 2 vs 1 EpiPens.
Didn't anakits have a syringe of epi and a couple Benadryl to treat the possibility of two types of reaction? Off to research.
Yeah, I think so. But this new standard is only a couple of years old which is why people haven't really heard too much about it.
I love ya Dianah but I don't think this is off topic. Safety first.
Like the story about the girl who died, her anaphylactic reaction started when the rice crispy treat made with some kind of peanut byproduct went into her mouth. Just because she didn't react violently at first, doesn't mean it wasn't anaphylaxis.
If anyone watched that short video, the physician said always give epi. Regardless of the strength of the reaction to the allergen. I used the video for training.
As to the cost of epi I'm wondering if the school districts get it for free if there isn't a program for kids with an Rx. Just wondering.
Looks like folks have offered lots of options for getting it cheaper.
Specializes in Complex pedi to LTC/SA & now a manager.
Yeah, I think so. But this new standard is only a couple of years old which is why people haven't really heard too much about it.
I love ya Dianah but I don't think this is off topic. Safety first.
Like the story about the girl who died, her anaphylactic reaction started when the rice crispy treat made with some kind of peanut byproduct went into her mouth. Just because she didn't react violently at first, doesn't mean it wasn't anaphylaxis.
If anyone watched that short video, the physician said always give epi. Regardless of the strength of the reaction to the allergen. I used the video for training.
As to the cost of epi I'm wondering if the school districts get it for free if there isn't a program for kids with an Rx. Just wondering.
Looks like folks have offered lots of options for getting it cheaper.
My son's school nurse purchases epi & albuterol plus stock glucagon. They get a discount on the EpiPens as all schools in the county purchase together in bulk. Every single public school & approved private school for students with disabilities has at least one certified RN/BSN nurse in my state. They have large buying power
OP's question about the cost of the Epi-Pen has great merit for discussion.
This is where the rubber meets the road.
Some good suggestions have been offered, thanks to all participating members. :)
I wish that we had greater literacy all around. I don't know how long alternate brands of epi auto injectors have been around, but I hadn't seen any when I left the pharmacy in 2011, and I hadn't heard of them until this thread. It's a nice idea to want every single patient to be aware, educated, & proactive about these things, but that's a tall order for non-healthcare folk.
I think the best place to target change is with doctors and pharmacists. Doctors who know that insurance may jerk you around and let you know "If you have trouble affording this, there are a few things we can try to help." Same thing with pharmacists, so that when they encounter a problem, they know how to advocate for the patient by advising the doctor if the prescription can be changed so something that is more affordable (talking about epi and in general).
Specializes in Complex pedi to LTC/SA & now a manager.
My husband has two epi-pens - our copay was $12. We don't have incredibly wonderful insurance that pays everything, either......
Something sounds odd with the cost you're getting.
Melissa
Last refill my copay was $100 as it was non-preferred brand, generic not yet available, AviQ not covered and was being pulled off the market. I had the manufacturer coupon for up to $80 off so it cost me $20.
The year before "insurance" covered $3.02 discount the pharmacist had an in house discount program for life saving drugs for underinsured and it was ~$106 (cash price was over $400). I justified it as cheaper than a funeral or ICU stay...
Good to know that there is now generic as the techs aren't always aware and insurance doesn't always push to generic alert when first released
There is a less expensive alternative, adrenaclick. About 200-300 dollars for two pens. you may get far better insurance coverage for them vs brand name.
Specializes in Complex pedi to LTC/SA & now a manager.
There is a less expensive alternative, adrenaclick. About 200-300 dollars for two pens. you may get far better insurance coverage for them vs brand name.
My insurance considers adrenaclick a "not preferred brand". Go figure
My insurance considers adrenaclick a "not preferred brand". Go figure
Insurance companies are weird. Sometimes this kind of thing is ok and sometimes not.
It should truly be what the physician thinks is the best medication for the patient - and let's face it, epinephrine isn't a brand new drug and very expensive to manufacture.
Specializes in Complex pedi to LTC/SA & now a manager.
Insurance companies are weird. Sometimes this kind of thing is ok and sometimes not.
It should truly be what the physician thinks is the best medication for the patient - and let's face it, epinephrine isn't a brand new drug and very expensive to manufacture.
As of July 1 EpiPen is now $30 copay for two pack...this is a very odd plan.
However the info is good to know to help others. Especially the member who posted the NDC numbers. I've used that to get a patient the needed dose of DiaStat. The 20mg unit can be set from 12.5 to 20mg. The pharmacy was sending a 10mg and 5mg pack (double copays) to make a 15mg dose. Once given the NDC they ordered the 20mg units they could set to 15mg for a single copay
That's the company that gave us the free epipens . . . with an Rx though. A law was passed here in CA mandating all schools had to have emergency epipens. That did not make physicians very happy and they fought it and put some caveats in the law. But it passed and we all had to scramble to find a physician to write the Rx.
dianah, ASN
8 Articles; 4,724 Posts
Gosh, apologies for taking the thread off-topic.
Really!
OP's question about the cost of the Epi-Pen has great merit for discussion.
This is where the rubber meets the road.
Some good suggestions have been offered, thanks to all participating members. :)