If you’ve been part of the food allergy community for a while, you likely remember the EpiPen pricing controversy.
If not, here’s a quick recap:
Between 2009 and 2016, Mylan (the owner of the EpiPen epinephrine auto-injector) increased the price of this life-saving medication from $103 to $608 (a 590% cost increase!). Back then, there was only one alternative on the market, giving Mylan an effective monopoly. Unsurprisingly, many could not afford the medication at this higher price point, and frustration among consumers, healthcare workers, and lawmakers quickly spread.
Then what happened?
In 2017, after news broke of the price hike, lawsuits ensued. First, Mylan was accused of knowingly misclassifying the EpiPen as a generic drug so they could circumvent government rebates—a violation of the False Claims Act, potentially overcharging Medicaid by as much as $1.27B. Mylan eventually settled this claim for $465M. Shortly thereafter, plaintiffs filed class action lawsuits against Mylan, and the manufacturer and seller of EpiPen, Pfizer. Pfizer eventually settled for $345M in 2021, and Mylan for $264M in 2022.
Suffice it to say, the scandal rocked the pharmaceutical world. It also paved the way for groundbreaking legislation around drug pricing.
New epinephrine laws
In the wake of public outrage, lawmakers around the country started working on legislation to cap out-of-pocket costs for epinephrine. Between these policy efforts and new epinephrine products entering the market, prices started to come down.
Earlier this month in Illinois, Governor Pritzker signed into law a bill that would cap the cost of epinephrine in the state at $60 for a twin pack of auto-injectors—an important precedent for other drug companies who manufacture and sell life-saving medications and devices.
Similarly, in 2021, Colorado passed a law capping out-of-pocket expenses for insulin. In February of this year, their House of Representatives approved the same bill that Illinois passed to cap out-of-pocket costs for epinephrine at $60 for a twin pack. This bill is currently under consideration in their state Senate. In Rhode Island, a similar measure would require insurers to cover epinephrine at no cost.
So, what’s next?
While it remains to be seen whether other states will follow Illinois and Colorado’s lead, one thing’s for sure: public demand for affordable healthcare is being heard. This year, insulin out-of-pocket costs were capped at $35 per month for senior citizens on Medicare, a 70% cost reduction for the majority of seniors.
It goes without saying that it can be difficult and expensive to manage food allergies (as a mom of a child with food allergies, I know that firsthand! 🙋♀️). But it’s encouraging to see so many people in our corner fighting for fair and equitable coverage for all.
— Meg and the Amulet Team
If you’d like to learn more about epinephrine, check out our blog for a flurry of epinephrine-related topics, curated for you here!