Increase of more than 400% in the cost of EpiPen in the US is unlikely to translate to higher prices here, says Allergy and Anaphylaxis Australia president
Mylan is under increasing scrutiny for gradually raising the price of EpiPens over time: from a wholesale price of almost US$57 in 2007 to over US$300 per shot.
Several US Senators are expressing concern about the hike, with Virginia Democrat Senator Mark Warner, who has a child with severe allergies, pointing out in a letter to Mylan that Epipen, “plays a critical role in ensuring the health and peace of mind for many of the one in 13 children with food allergies.
“I am deeply concerned by this significant price increase for a product that has been on the market for more than three decades, and by Mylan’s failure to publicly explain the recent cost increase, which places a significant burden on parents, schools and other purchasers of the EpiPen,” Senator Warner wrote.
The American Medical Association and Asthma and Allergy Foundation of America have also expressed concern.
— AMA (@AmerMedicalAssn) August 24, 2016
Maria Said, president of Allergy and Anaphylaxis Australia, told the AJP that pharmacists can reassure concerned Australian allergy patients that prices here are stable and unlikely to change, whether patients are filling scripts or buying the devices over the counter.
“Our experience has been that there has been no real increase in EpiPen price since the early 1990s, when it first came to Australia,” she says.
“Individuals can get two devices on the PBS if they’ve been diagnosed as at risk of an anaphylactic attack, and over the counter the device costs $100 – a little more in remote areas, but the average price is $100.
“We know that more and more people and organisations are purchasing devices over the counter, and if that price were to increase to the pharmacy, that cost would be incurred by the individual purchasing it – and we haven’t had to communicate with Government or anyone else about the availability of these devices.”
Individuals often buy an extra EpiPen or two over the counter to give them the peace of mind of knowing one is not far away, she says.
Said says Australia has led the way in encouraging organisations, including schools, camps and workplaces, to buy EpiPens over the counter for general use in first aid kits.
She says that as well as reassuring Australians that prices are likely to remain stable, pharmacists can also help encourage patients to replace their EpiPens before they expire and to ensure they have an Australasian Society of Clinical Immunology and Allergy (ASCIA) action plan.
“It’s important to be mindful of the expiry date and to replace the device before it expires, because after that the degradation means the adrenaline won’t be as effective – it’s an emergency drug and so you need it to be as effective as possible,” she says.
“We encourage consumers to shop for a device with a long shelf life, and we have an EpiClub they can join which offers a reminder service – but we’re certainly aware that it does happen that people don’t replace their device on time.
“There are some people who don’t have an ASCIA plan, an emergency response plan that everyone prescribed an EpiPen must have.
“Some people fall through the cracks and their GP doesn’t provide one, so having pharmacists ask a simple question about whether they have one, having a trainer on hand and showing them how to use one, doesn’t at all go astray.”
Said also encouraged pharmacists to participate in ASCIA’s online training, which attracts CPD points.
This week the American Pharmacists’ Association shared an article outlining the problems associated with the skyrocketing price of EpiPens combined with costly copayments even for Americans with health insurance.
- For insured patients, help them secure a coupon from the manufacturer to reduce the price of the copay.
- For uninsured patients, help them enroll in a patient assistance program that will provide EpiPens free of charge.
- Make prescribers, patients, and other pharmacists aware of an available generic product. Prescriptions need to indicate epinephrine auto-injector, not EpiPen.