EpiPens: A Life-Saving Necessity or Luxurious Expense?
Millions of Americans suffer from life-threatening allergies, whether the antigen are peanuts, shellfish, or latex. The one line of defense these people possess in the instance that they suffer from an anaphylactic attack is the epinephrine auto-injector. Epinephrine, also known as adrenaline, acts as a bronchodilator and vasoconstrictor, effectively opening a patient’s airway and allowing adequate blood flow to the heart and lungs by diverting it from the extremities. There is no other medicine that has these same effects. It is becoming more and more difficult for Americans to procure this pharmaceutical because of its ever-increasing price. This has become such a concern that one individual opted not to use her EpiPen during an allergic reaction because of the cost to replace it.
Mylan, the company that produces the ubiquitous EpiPen, owns about 90% of the $1.3 billion U.S. auto-injector market and has increased its price of an EpiPen by 450% since 2004 (Iozzo). In 2004, the price of an EpiPen was $150, but has since skyrocketed to over $600. That cost reflects one dosage, but Mylan only sells EpiPens in packages of two. The pharmaceutical giant argues that a backup auto-injector is necessary in case the first one malfunctions. Therefore, buying this life-saving medicine costs consumers about $1,200. The actual epinephrine only costs Mylan one dollar to produce; the astronomical price of the product is mainly due to the company’s proprietary pen injector. Only recently, after much public pressure, has Mylan offered a discounted price on their EpiPen. However, even with this discount the product still costs well over $1,000. As a result, many consumers have attempted other ways to treat their allergies. An alternative company named Adrenaclick has emerged in the auto-injector market with a much cheaper product, selling for $142. While this product is much more affordable, doctors are hesitant to recommend it because the steps to use this new product are drastically different from those of the EpiPen (Cha). Since the EpiPen has monopolized the market, using a different product with different injection procedures will take time and practice. Doctors do not want individuals taking time during an emergency to stop and read the directions on how to use this relatively new product. Additionally, individuals have begun to create their own concoctions of epinephrine and use that in place of an EpiPen. This latter trend greatly worries legislators, particularly Iowa Senator Charles E. Grassley: “I am concerned that the substantial price increase could limit access to a much-needed medication. It could also create an unsafe situation as people untrained in medical procedures are incentivized to make their own kits”. The alternatives to using EpiPens are not very well established, so many consumers are forced to pay the exorbitant amount to use Mylan’s product. Those who cannot afford an EpiPen are turning to very drastic and radical measures to protect themselves in case they suffer an allergic reaction.
Alyssa Rosenberg has suffered from a severe tree-nut allergy since she was a toddler. Because of this diagnosis, she has needed an EpiPen for practically her entire life. Alyssa has lived a very functional and fulfilling life, as many allergy-sufferers do. However, last spring she had to make a decision after unknowingly eating kale chips that were seasoned with cashew dust. She reasoned that she would not have to go to the hospital, so rather than using her EpiPen she made herself vomit. Rosenberg went on to say that her health insurance plan is very expansive and that she rarely has allergic attacks. The attack she had last spring was the first one she had had in about ten years. Even though all of this is true, she still believed that not using her EpiPen was the best thing to do when she had an allergic reaction. There are many individuals in the United States who have very poor health insurance programs and use their EpiPens several times a year. The cost of replacing EpiPens to them is most daunting, and must be mitigated so that people do not have to think twice about using their EpiPen in the appropriate situation.
Epinephrine injection is the only way to treat anaphylactic shock in a patient, and the EpiPen is the only credible product available to people suffering from anaphylaxis. Mylan has consistently raised the price of their EpiPen over the past twelve years, which has greatly reduced individuals’ ability to purchase the device. This inability to access an EpiPen has lead people to make radical and potentially-dangerous decisions about treating their allergic reactions.
Cha, A. E. (2016). U.S. lawmakers demand investigation of $100 price hike of lifesaving EpiPens. The Washington Post. Retrieved from https://www.washingtonpost.com/news/to-your-health/wp/2016/08/23/u-s-lawmakers-demand-investigation-of-100-price-hike-of-life-saving-epipens/?tid=a_inl.
Iozzio, C. (2015). How one startup plans to end the EpiPen monopoly. Fortune. Retrieved from http://fortune.com/2015/07/21/epipen-alternative-medicine/.
Rosenberg, A. (2016). EpiPens are my armor against disaster. They shouldn’t be priced like a luxury. The Washington Post. Retrieved from https://www.washingtonpost.com/news/to-your-health/wp/2016/08/25/epipens-are-my-armor-against-disaster-they-shouldnt-be-priced-like-a-luxur