Epi-Pen price increases make life difficult, dangerous for students

Wednesday, September 14, 2016 - 5:28pm

Students with allergies at the University of Michigan and across the country have recently been affected by the rapid price hike of EpiPens — syringes that are preloaded with epinephrine — which are used to offset life-threatening allergic reactions.

According to the Wall Street Journal, Mylan — the company that produces and manufactures EpiPens — has increased the list price by more than 550 percent over the last eight years, with the price now hovering around $600 for a set of two. During the same eight year period, Mylan CEO Heather Bresch’s salary rose from approximately $2.5 million to $19 million.

There are also few alternative epinephrine injection drugs currently available — EpiPen’s primary competitor, Auvi-Q, was recalled last October due to potential inaccurate dosage delivery. The EpiPen also expires every several years, some as soon as 12 months after purchase.

The anaphylactic reactions that EpiPens treat are life altering — with symptoms including hives, stomach pain and swelling of the throat — and can affect individuals with food allergies, even if they have not had a severe reaction in the past.

Georgiana Sanders, M.D., a University Health System clinical assistant professor who works at the University’s allergy clinic, said it is necessary for anyone with a food allergy to carry two EpiPens with them at all times.

“The reaction someone has one time is not necessarily the reaction they will have another time, which is why it is necessary to carry around an EpiPen,” Sanders said. “You can’t predict from one reaction to the next.”

LSA sophomore Angela Peters hasn’t owned an EpiPen since elementary school, despite her anaphylactic reaction to peanuts. For Peters, life would be much safer with an EpiPen at hand, yet for that to happen, a significant price change would need to happen.

“I haven’t had an EpiPen since late elementary school. My mom would stop buying them because they would expire,” Peters said. “She would have to buy EpiPens every year and they are so expensive.”

According to The New York Times, Mylan has offered commercial insurance patients a coupon of $300 that can be obtained from a physician or on the EpiPen website. However, some families who are less able to afford the EpiPen prices — uninsured families and families on Medicare and Medicaid — are ineligible to receive the coupon.

LSA sophomore Erica Schuman said she is lucky to receive the rebates from her doctor that make EpiPens more affordable, but noted that there are others who are not as lucky.

Because of Mylan’s control of the drug market for epinephrine injections, patients have few options other than to purchase an EpiPen. Sanders said while quite a few of her patients are forced to cut back on EpiPen purchases due to financial constraints, she assists clients in finding alternative funding via University social workers or the organization Needy Meds.

“Another way that patients are saving money is to continue using the Epipen after the expiration date, as long as it is not cloudy,” Sanders said. “Unfortunately, there is some data that the epinephrine begins to lose effectiveness so this is a potentially risky practice.

Some patients have also turned to drugs other than epinephrine injections to subside their reactions, such as Benadryl — an allergy medication that is also used to treat pain and itching.

Schuman, who uses an EpiPen to treat her tree nut allergy, said she’s found Benadryl isn’t as effective because it can take up to 30 minutes to kick in. She said she believes it is the responsibility of Mylan to ensure that those with severe allergies are able to purchase EpiPens.

“I think it is not only unfair, but unethical to exploit people’s health and safety for profit,” Schuman said.

In the past few months, the price surge has caught the attention of several senators, as well as Democratic presidential candidate Hillary Clinton.

Late last month, Sen. Susan Collins (R–Maine) and Sen. Claire McCaskill (D–Missouri), sent a letter to Bresch, voicing concerns about the EpiPen price increase and the effects on the health of Americans. On Sept. 2, in response to the controversy, Hillary Clinton announced a plan to address excessive increases in drug prices that includes giving the government the power to fine drug companies. The plan would hold drug companies like Mylan accountable for creating unreasonable prices for products when lives are at stake.

Sanders said there is also the potential for new drugs to enter the market, but noted the cost is burdensome and the process takes time.

“The price of developing new drugs such as things like peanut oil immunotherapy are astronomical,” Sanders said. “About one in 16 drugs that a company starts to produce actually make it to clinical trial. Then it costs millions of dollars to run the trial according to FDA regulations.”

In the meantime, to compensate for the absence of the epinephrine injection she can afford, Peters said she makes sure to be extra cognizant of what she eats, though one slipup could put her health in danger. She noted that many people have even more of a dependence on the medicine.

“My allergy isn’t even that serious compared to people whose allergies are airborne,” Peters said. “For some people, having an EpiPen or not is the difference between life and death.”