Janis Wolfe has a severe tree nut allergy that twice caused her to go into anaphylactic shock.
The first time it happened, she was 4 and had no memory of the incident, so the Bellingham resident didn’t have an EpiPen, the auto-injector that dispenses the drug epinephrine, when the second incident sent her to the emergency room in February 2006 when she was 23 after one bite of a chicken salad wrap that contained pecans.
Within minutes, she vomited. Her lips, eyelids and face swelled. Hives erupted on her torso. She lost her vision and then consciousness as a nurse put an IV into her that included the drug epinephrine.
The EpiPen is being battered publicly after Mylan, its maker, was found to have raised the price by 450 percent since 2004. The medicine inside the EpiPen doesn’t cost much. It’s Mylan’s proprietary auto-injection system, which delivers an accurate dose, that is expensive.
There’s been a groundswell of anger, with consumers and lawmakers alike saying the steep increase is putting the lifesaving product out of reach.
It is outrageous that a pharmaceutical company can ransom the lives of patients with uncontrollable, life-threatening allergies.
Janis Wolfe of Bellingham, who has a severe tree nut allergy
Wolfe is among them.
“EpiPens are almost certainly the reason I am alive today,” she said. “It is outrageous that a pharmaceutical company can ransom the lives of patients with uncontrollable, life-threatening allergies.”
She has carried an EpiPen since that 2006 incident, using one after biting into carrot cake that contained walnuts.
Wolfe, who has had a high deductible health insurance plan for a while, said she noticed that the price was increasing about four years ago. Two years ago, when she tried to refill her prescription, she was shocked to learn that her out-of pocket cost was just under $500.
That price is even higher now, with consumers paying more than $600 out of pocket for a pack of two EpiPens, the only way they’re sold in the U.S.
But she can’t afford to replace the one she has now.
“The only EpiPen in my possession, which is located in my purse at all times, expired this past July. I have no plans to replace it any time soon. I intend to base when I replace it on when the solution appears discolored,” she said, referring to the window that shows the medication in the EpiPen.
Wondering, like Wolfe, how to get the medication you need given the price hike?
Here are some options, if you’re willing to put in some work:
▪ Apply for a My EpiPen Savings Card to reduce your out-of-pocket expenses by as much as $300 per two-pack. That’s up from $100. The card won’t cost you anything, and you’ll qualify if you have health insurance. Find it by going online to epipen.com/copay-offer. You can’t use the card with coupons or other offers.
▪ See if you qualify for EpiPen’s patient assistance program. Fill out a form by going online to epipen.com/en/resources. You also can email firstname.lastname@example.org or call Mylan customer relations for free at 800-395-3376 to speak with a representative. Mylan has doubled the limit for eligibility, so a family of four making up to $97,200 would pay nothing out of pocket, according to an AP story.
▪ Buy online from Canadian pharmacies. The average price for a two-pack of EpiPen was about $620 in the U.S. with a coupon or discount, according to GoodRx. Online Canadian pharmacies were selling the same thing, which dispense doses for adults and bigger kids, for about $225 U.S., according to canadadrugs.com.
“We’re able to provide this service to Americans to help them maintain their regime, whatever it may be, and certainly in the case of EpiPens to have it available to them,” said Tim Smith, general manager for the Canadian International Pharmacy Association.
That difference in price has prompted a surge in Americans ordering their EpiPens from Canada, which controls price increases for medication.
“There’s definitely an increase year over year,” Smith said.
You’ll need a prescription from your doctor in the U.S. to buy online.
Be sure to ask about the expiration date.
Wolfe said the more affordable price she got when she ordered “was offset by the gamble that EpiPens bought through the site offer no guarantees the expiration date will be more than six months away.”
The normal expiration date is about a year.
Smith said pharmacies in his group are careful with expiration dates.
▪ Drive over the border to Canada to purchase one. Unlike buying online, you don’t need a prescription to buy in the pharmacy. But the EpiPen is behind the counter so you’ll need to ask for it, according to Shoppers Drug Mart in Abbotsford, British Columbia.
▪ Shop around for the best prices and financial assistance. GoodRx.com is a good place to compare prices. Also check out Needymeds.org and Familywize.org. The latter offers a prescription savings card to consumers regardless of income. Its free prescription savings card and app are accepted at more than 60,000 pharmacies nationwide.
“FamilyWize is focused on trying to reduce the effects of these increases by making medications affordable through the best discounted price possible,” said Joseph Sanginiti, its president and chief operating officer. “We are seeing across the country more people turning to FamilyWize to help afford all of their prescription medications.”
▪ Talk to your doctor about Adrenaclick, also an auto-injector that gives a dose of epinephrine. Paired with a coupon from GoodRx, it could be cheap as $145 at Walmart for a packet of two that dispense doses for adults and bigger kids. Otherwise, the price is about $400.
It works like the EpiPen, in that patients give themselves a shot in the leg. But the Adrenaclick requires people to take off both ends before use, unlike an EpiPen – which is so ubiquitous that people are more accustomed to it.
Dr. Jim Hopper of Bellingham Bay Family Medicine said Adrenaclick was an option but noted the difference.
“It is somewhat more awkward to use,” Hopper said of Adrenaclick, “having twin caps to remove before use.”
▪ Ask your doctor for a prescription for an ampoule of epinephrine, the inexpensive medication that reverses the symptoms of anaphylaxis, and a syringe. You’ll have to learn how to draw the right dose into the syringe and give a shot, which could be tough in an emergency, but it’s better than going without the medication. The cost is $5.
“I’d really recommend they talk to their provider rather than going without because they can’t afford it,” Hopper said. “That’s the best recommendation I can give.”
▪ Revisit with your doctor whether you actually need an EpiPen. If you step on a bee and your foot swells up, for example, then you likely can do without, said Hopper, who also is the chief medical officer for Family Care Network.
An EpiPen is for symptoms of anaphylaxis, the most dangerous of which are low blood pressure, difficulty breathing and loss of consciousness, all of which can be fatal.