A new study has found that despite the availability of low-cost options of epinephrine auto-injector, people are still paying higher price and that these epinephrine auto-injector are proving to be costly for some.
Though people are paying less now for epinephrine auto-injector, for a significant minority the amount they pay has stayed high – largely due to their health insurance plans.
The authors analyzed 2015-2019 data from 657,813 children and adults using the IBM MarketScan Commercial Database, which is a national claims database from 28 million Americans with private employer-sponsored insurance. During this period, the branded EpiPen faced increasing competition, including from its own lower-priced authorized generic, the authorized generic of Adrenaclick. and a generic auto-injector manufactured by Teva.
Th authors found that mean annual out-of-pocket spending for epinephrine auto-injectors peaked in 2016 at $116 and began to decrease in 2017, when patients increasingly shifted away from the EpiPen to lower-priced competing products. By 2019, mean annual out-of-pocket spending had fallen to $76, and 60% of patients paid $20 or less for epinephrine auto-injectors.
Despite this improvement, 1 in 13 patients paid more than $200 for epinephrine auto-injectors in 2019. Among these patients, 62.5% were enrolled in high-deductible health plans. These plans cover approximately 30% of privately insured Americans and had a minimum deductible of $1,350 for individuals and $2,700 for families in 2019.
63.3% of the patients paying more than $200 per year were children. Researchers believes this is partly because children need to fill prescriptions more often than adults so that they can have epinephrine auto-injectors both at home and school.
Almost two-thirds of patients paying more than $200 per year only used lower-priced non-branded products, like the authorized generics of EpiPen and Adrenaclick. Among these patients, mean annual out-of-pocket spending was over $650, and 88% of this was in the form of deductible and co-insurance payments.