By Emma Court

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The story is an all-too-familiar one: company buys dated drug, raises prices and impedes patient access to life-saving treatment in the process.
This time, the target of the tired narrative is a medical device with an unusual amount of brand name recognition, effectively no alternatives and a growing patient population — Mylan Inc.’s EpiPen.
The price of the EpiPen, which treats emergency allergic reactions, has climbed sixfold over the last several years. At drug price-comparison website GoodRx, the cheapest price today is $614 for a package containing two, or more than $300 per EpiPen, up from about $100 for two.
“Until there’s a better alternative, anyone relegated to an EpiPen is going to be carrying it to a very distant future.”
Dr. Beth Corn, associate professor of medicine, Mount Sinai School of Medicine
What that price increase means for patients varies dramatically, depending on health insurance coverage. Mylan calls its savings program the “$0 co-pay card,” but it only decreases out-of-pocket expenses by $100 — enabling a free or low co-pay for those with good insurance plans, but barely making a dent for those with increasingly common high-deductible plans or no insurance.
Read more: This is what your health insurance looks like this year
When Nicole Smith took her son’s EpiPen prescription to her local Walgreens /zigman2/quotes/203410933/composite WBA -1.35% , she balked at the $600 price quote for a two-pack. Her high-deductible health plan meant Mylan’s “$0 co-pay card” would only bring the cost down to $500.
Smith, the founder of an online community to support food allergy families called Allergic Child , couldn’t swing that. She did some digging and found that the generic device — called Adrenaclick — is designed slightly differently. At $400 for a two-pack, it also wouldn’t be much cheaper.
For patients, EpiPen’s increasing cost is also exacerbated by the difficulty of procuring the generic, which holds a very small portion of the market, and the recall of a competitor, Sanofi’s /zigman2/quotes/201967021/composite SNY -0.58% Auvi-Q, late last year.
See: Allergy sufferers scramble after Sanofi recall

Dr. David Stukus, a pediatric allergist and associate professor at Nationwide Children’s Hospital in Ohio, says he’s heard a lot of frustration from families who can’t afford their medication. Some patients have opted to rely on expired EpiPens or make difficult decisions about what medications they can afford for their children, he said.
“I hear this at least once a week, if not every day,” Stukus said.
He also hasn’t seen anything to warrant the higher cost. “I don’t think the device has changed at all, but I think the supply and demand have changed dramatically,” he said, noting that there has been a sizeable increase in reported food allergies among children over the last decade.





