2 Years After the EpiPen Price Hike—Here’s What’s Changed

Tori Marsh
Tori Marsh, MPH, is on the Research Team at GoodRx, and is the resident expert on drug pricing and savings.
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In the two years since a national controversy erupted over the price of EpiPen injectors, the market for epinephrine auto-injectors has changed dramatically, according to a GoodRx analysis of US prescription fill data.

Where two years ago, EpiPen, manufactured by Mylan pharmaceuticals, had nearly 90% of the market for the medication, today the EpiPen brand auto-injector accounts for just around 10% of fills. Instead, the generic version of EpiPen (also manufactured by Mylan) now holds more than 60% of the market, with a generic version of the Adrenaclick auto-injector accounting for another 30% of the US market.

The difference is all about price. Since generic EpiPen—epinephrinereached the market in December 2016, the price of EpiPen has held steady at around $700 for an auto-injector two-pack, and the price of the EpiPen generic has stayed level at around $400 per twin pack. (The devices are typically sold in a package with two auto-injectors.) The price of brand-name Adrenaclick, which accounts for a small fraction of US prescription fills, is around $500 per twin pack, while the price of generic Adrenaclick has stayed between $200 and $300 per twin pack. CVS sells the generic Adrenaclick for just $110 for two auto-injectors.

The effective ingredient in all the auto-injectors is epinephrine, which narrows blood vessels and opens airways in the lungs. This can quickly reverse severe allergic reactions that can be especially dangerous. The devices are widely prescribed for children for emergency purposes, and there is often a surge in prescriptions in the late summer, as parents get prescriptions to keep at their children’s schools, in preparation for the new school year.

Unlike for many generics, which are manufactured by competing pharmaceutical companies from the brand-name manufacturer, the generic versions of both EpiPen and Adrenaclick are made by the same manufacturer—Mylan in the case of EpiPen, and Impax Laboratories in the case of Adrenaclick. That’s about to change though. On August 16, 2018, the FDA approved the first generic version of Mylan’s EpiPen to be manufactured by an outside competitor, Teva Pharmaceutical Industries. Stay tuned for updates about pricing. 

In August 2017, Mylan reached a $465 million settlement with the US Justice Department for overcharging the US government for EpiPens.

This report is based on an analysis of more than a million prescription fills in US pharmacies. The data comes from a representative sample of prescriptions from 75,000 pharmacies across the US.

So what are my options now?

Because of its time in the limelight, EpiPen is the most well-known of all the auto-injectors, but there are others available you may want to consider.

The generic version of Adrenaclick is the most popular alternative to both EpiPen and the generic version of EpiPen. Like EpiPen, Adrenaclick is a pen-shaped auto-injector that comes in dosages for both Adults and children. If your insurance won’t cover your auto-injector, generic Adrenaclick may be a good option for you—CVS now sells it for $109.99.

During the EpiPen pricing controversy, manufacturer Kaleo made it their mission to develop an affordable autoinjector and released Auvi-Q. The average cash price for Auvi-Q is expensive, but the manufacturer has made it easy for many patients to access it for free through the Auvi-Q Affordability program. You can read more about this program here.

We will soon be able to add a fourth auto-injector to the list. This August, Novartis announced that they will soon begin distribution for a new auto-injector, Symjepi. While Symjepi’s price has not yet been released, a recent study revealed that it might result in fewer user errors than EpiPen. Stay tuned.

Lastly, if EpiPen works best for you, make sure you’re taking the generic. The only difference between the brand and generic is the name, so you won’t have to relearn a new system entirely. Additionally, Mylan also offers a manufacturer program for insured patients, though it only offers savings up to $25 per fill. Read more about this program here.

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