Imagine if Epi Pens were like test strips

And you got the dreaded add more blood.

That would cost

Are you high? (And I’m not talkin’ blood sugar…)

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I think this is referring to the controversy that Mylan has been gouging the price of Epi-pens, leveraging their monopoly and raising the price of this medication (that has been on the market 30 years and is no longer protected). They have raised the price by 500% since 2009 and 150% since 2013. A box of 2 epi-pens costs $600. It should probably cost about $6.

If you used an Epi-Pen and it “failed” it would cost you $300. Ouch.

Or cost you your life.

Mylan is doing the unconscionable

The EpiPen should be OTC
Just as Metformin should

Yeah, it’s pretty awful. And just like with the diabetes supplies, the insurance companies are making it rougher. My insurance company insists that I use epipen’s competitor. They won’t budge on this. Despite the fact that their preferred product was recalled and is off the market. When I pointed that out, I was told that if I felt like I needed the non-formulary one, I was welcome to pay out of pocket. Umm, yeah, I do feel I need it to not die. But, no, I don’t want to pay $600 for it.
In researching options, there was a generic. Asked the allergist for it. She was surprised I even knew about it, as doctors don’t like the delivery mechanism and almost never prescribe it. My local Cvs, not a small pharmacy, had never even heard of the generic one! Have to choose between regularly paying $5 for one that isn’t considered as safe vs $600 for one that is. There’s no way that the delivery mechanism difference is special enough to warrant that much higher a price.
It’s awful that Epipen’s manufacturer is exploiting their monopoly when lives are at stake. But the insurance companies and their greedy adherance to formularies that are based on money alone don’t help the situation.

Let’s hope it wouldn’t fail, though. The stakes would be exponentially higher than a test strip failing. There was a rival autoinjector called Allerject (Auvi-Q in the US) that was pulled from the market in November due to some devices failing to deliver the full dose of epinephrine. Shame, too, because it was a far better device and far smaller to carry (important when we’re supposed to carry two at all times), but its disappearance is partly why Mylan has a virtual monopoly in the US.

Luckily, in Canada we have more regulations and our EpiPens are distributed by Pfizer, so there’s been no price increases here, though a single EpiPen still costs about $120 when it should cost $6.

This has been covered in the media recently. One discussion I listened to revealed that there is an alternate solution using a vial and syringe that costs much less. I think they said $30-$40.

Like our glucagon kits, doing the extra step when caught up in all the emotions of a life threatening emergency can be a significant difference. I think if I or a loved one had this risk, I would practice with the syringe and vial to overcome the stress of the emergency.

I think this demonstrates yet again that Big Pharma has no morals and no allegiance to anything but the bottom line. Insulin should not cost hundreds of dollars per vial, either. Insurers and pharmacy benefit managers combined with Big Pharma and a cloud of secrecy to remorselessly steal. Funny that this is only a problem in the US.

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In Canada, I think a vial of epinephrine and a syringe cost something like $5. The major drawback of it is that, like a glucagon kit, don’t expect anyone to be able to use it who hasn’t specifically been trained. And don’t expect to be able to self-administer in an emergency. There are several glucagon autoinjectors in development and I, for one, will be getting one as soon as it’s on the market. An autoinjector literally takes two or three seconds to use and takes minimal training to learn how to use.

I see the wisdom in your suggestion. But if people face an unaffordable but simpler choice versus one they can afford, even one with a training burden, then I think securing an affordable one that will still work is a rational choice.

This whole discussion underlines the inferiority of the current US healthcare system.

My epi pens have expired and that monopoly price is . . . well, I can’t use that language here.

I am going to look into the generic epinephrine. Where do you get information about dosing? And what type of syringes do you need?

While I have no direct experience, the discussion I’ve heard on this topic claimed that the epinephrine in a vial comes as a kit with an appropriate syringe.

I’d talk to your allergist. The autoinjectors come with 0.3 mg of epinephrine in them. So maybe there are syringes that measure in 0.1 mg increments.

The best would be to get one or two pre-measured and then put them in one of those plastic cases meant for pre-measured insulin syringes (if whichever kind of syringe you need would fit). That way they would be all set to use in an emergency. Although I’m not sure if sitting in a syringe would make the epinephrine go bad with time, it probably would, come to think of it.

I’ve also read a study somewhere (can dig it up if you’d like) that said that EpiPens are still good well past their expiry date. If given a choice a new one is better, but an expired one will still work to some degree. (I think the study said that five years after the expiration date the epinephrine was still 80% effective.) I put my most recently expired EpiPens in my earthquake kit and keep the new ones in the bag I carry with my daily.

True, I was just comparing the pros and cons. But if someone can’t afford the autoinjector, having the vial and syringe is far better than nothing.

The one that I have now is the generic form of Adrenaclick, which I hadn’t heard of. But it’s available, or at least was back in January when I got it. It’s in pen form but different than the epipen. If you don’t want to switch to syringe for it.

Thankfully haven’t needed to use it so I can’t tell you how it works.

This.

Ditto.

I’ve pointed this out before, but it’s been a while. In Germany, there is a federal law that no prescription med can be sold for more than 2000% of what it costs to make. That sounds like a huge markup, but wait: it means that a vial of insulin that costs, oh, $1.50 to make can never ever be sold for more than $30 under any circumstances. Here in the good old USA, that vial costs . . . well, you know what it costs.

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I’ve just been having a discussion on Facebook with @acidrock23 and others about this, what the “real cost” of things are in Canada compared to the US. Here a vial of Apidra costs about $62 USD even if one just walked in and bought it at full price. But no one who is a citizen or permanent resident of Canada would do that, because the government covers 70% of the cost of rapid insulins (here in BC, this differs by province), which means the actual cost to the consumer is more like $19 USD. Similarly, a single EpiPen here costs about $92 USD, so the huge cost increase hasn’t affected us much, if at all. EpiPens aren’t covered by the government except for people who are low income here in BC, but they are usually covered by extended health benefits people get through work.

No one on Facebook knew what exact regulations were in place to make the price the way it was, or whether the government pays these pharmaceutical companies to “make up” the rest of the cost (I doubt it). But it seems that the US is the only country in the world where healthcare costs are completely unregulated and out of control.

To complete the picture, that vial of Apidra costs me $253 US. That’s without insurance. But even when it was covered, it cost me significantly more than the $62 you quoted.

I rest my case. Or, more precisely, OUR case.

OK, makes sense now. I was clueless.

Imagine you are drowning and someone is standing on the shore with a life preserver and a rope.

“That’ll be $600 in advance, please.”

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