I think I’ll ask for the Adrenaclick by name when I see my allergist tomorrow. She will be happy to learn it exists and may be able to help other patients who would not want to help Mylan fatten it’s coffers. Sadly, I suspect the Adrenaclick isn’t on the formulary–they may not have as strong a marketing team that will get and keep its wares on the formulary of insurers, which can affect the out-of-pocket costs to patients.
This is when my daughter is happy living in the UK; her Epipens are free!! She is home this week for her wedding, and we were just discussing where during the ceremony and reception she would keep her EpiPen; not looking to carry it down the aisle with her 
I offered dad’s coat pocket, and her wedding planner can have the second one.
All kidding aside, I remember when we would get a twin pack for $40; usually would keep 4 on hand at a time. One was in her purse, one in her knapsack, one in her dance bag and one in the nurse’s office at school. Luckily we threw most of them away each year, so it was $80 down the drain; worth it for her life. I could not imagine having to spend $600 at this point, but we would do what we had to do. As an adult, she now only keeps two around at a time, but one is always with her, and the other is backup.
With health care, there always are several problems, with prescription drugs there are a lot of problems, the insurance companies don’t care because when faced with higher prices, they jack up rates, and due to anti trust legislation they cannot get together and negotiate with the drug companies en masse to force better prices, the drug middle men get what they can, and the drug companies are going to charge what the market will take, because there aren’t really any effective price controls per se, other than public outrage and eventually competition. Drug companies have ties with doctors that are claimed to be ‘informational’, that studies have shown cause doctors to prescribe a name brand drug even though for the person in question, an existing drug may work just as well. We also allow prescription drugs to be advertised, the US is one of only two countries that allow that, and that influences things, people see the add and want that miracle drug that shows someone supposedly with bad athritis dancing and chasing their dog…it is the whole system, but that doesn’t take Mylan or the CEO off the hook, it is kind of hard to cry it is everyone else’s fault, when her compensation in the period between when they bought the Epi Pen and today went up 6x (and please, no one give me how the board of the company decides that, that it reflects performance,etc, you believe the board of directors really do that I have a bridge to sell you).
@greenwitch:
The answer to your question is that Canada like many countries have limits placed on the cost of medicines that can be sold there, unlike the US drug companies have to sell at the price specified by the government or they can’t sell it there, pure and simple. Drug companies will tell you that the high cost of drugs in the US is because they need to recoup their losses in other countries, which unfortunately relies mostly on hearsay, I have not seen actual data that shows, for example, that whatever the wholesale price of the drug is in Canada or some European country, they lose money on it (from what I recall of those laws, and this goes back a while, they supposedly factor cost into the equation and then tack on a certain percentage for profit). The drug companies say they can only make a reasonable profit charging what they do in the US to offset those losses, critics say that isn’t true, that the Pharm industry is some of the more profitable companies around and that the high prices simply represent what they can get, given the lack of price controls in the US (the insurance companies don’t care, they just jack up rates, the middle men don’t care, they make money at any price level). The largest medical care providers in the country, medicare and medicaid, are not allowed to negotiate drug prices the way pharm middlemen can, by direct action of congress (Interestingly, I seem to recall the VA is allowed to do that).Medicaid and Medicare because of their size has big influence on medical pricing, and the pharm industry knew the consequences if they negotiated prices, it could lead to other insurance companies doing that, too.
And yep, you cannot legally buy Canadian drugs, and it has nothing to do with the safety of them (Canada’s drug laws are as strict, if not stricter, than in the US), it is because Canada has price controls and the US doesn’t.
Drug companies do have a point, with new product development it is expensive, it is some of the least productive R and D out there (few drugs that start the process of being developed make it to being an actual product), but there also are questions about how profitable the companies are, how much their executives make (and it is not a small amount), and the rate of return to shareholders. The problem is taking something that is mature and doing what Mylan did or Shvelli, and there can be repurcussions for that, and even with new drugs for all the claims of high development costs, the products who don’t make it, drug companies are some of the most profitable companies out there.
Again,. the head of Mylan isn’t wrong that the whole system is a mess, but that doesn’t absolve them in this situation.
http://www.consumerreports.org/drugs/how-to-get-cheaper-epipen-alternative/ discusses Adrenaclick.
There’s a cartoon in the NY Times called “the strip” that tries to explain the health care craziness today in last weekend’s edition. I can’t seem to link it.
I called the preferred pharmacy, CVS and tried to find out the costs if I had my doctor order an Epi-Pen or the alternative injector. She said my out of pocket is $0 with the Epi-pen but can’t figure out what it is with the other injector and promised to get back to me.
I am still waiting for a call back from her. I told her I want the info for my allergist, whom I’m seeing today, so she has options for her patients.
I found coupons for both Mylan’s Epi-pen and the other injector, to reduce the out of pocket cost. Unfortunately the Mylan’s coupons have exclusions, including anyone on Medicare.
The CVS person said the other injector is classified as medical rather than pharmaceutical. She and I agreed that makes no sense that it’s classified differently from the Epi-pen, since they’re the same thing, just different brands.
I’ve been prescribed Epi-pens for about 16 years but have NEVER used any. I did return to my allergist once for a shot from her staff when I was having a bad reaction to an allergy shot administered by her office, but otherwise avoidance, inhalers and Zyrtec have been enough for me.
According to our insurer, the generic epinephrine pen is already out and available for purchase. Here’s an article by Consumer Reports on epinephrine pens. http://www.consumerreports.org/drugs/how-to-get-cheaper-epipen-alternative/
According to my insurer, if I buy a 90-day supply of the generic epinephrine pen, under my insurance plan, there is no copay. If I buy a 30 day supply, I believe there IS a copay of $7 or so. If I buy either Epipen or Adrenaclick, it’s preferred on my formulary so it’s $35 for a 30 day supply and $75 for a 90 day supply.
What constitutes a 30 day vs 90 day supply depends on how the physician writes the prescription and how the pharmacist interprets it. Sounds clear as mud to me! It looks like there are coupons for both name-brand pens, to help reduce the out-of-pocket costs (even to $0), IF you meet conditions and are NOT participating in any government plan like Medicare, Medicaid, etc.
There is a training video, as each injector has it’s own instructions as to how it is to be used and it’s important for the patient and anyone who may have to inject the patient to familiarize himself/herself with instructions. Mylan has a program to give each school 4 “free” auto-injector pens, according to their website.