Drug Inflation in the News: EpiPen

With drug inflation at the forefront of trend concerns in the pharmacy benefit industry, the rise in cost of drugs like the EpiPen have gained lots of press coverage in the past few months. Mylan, the maker of EpiPen, raised the price on their product from $57 in 2007 to more than $600 last year.

EpiPen is now facing increased market competition. The manufacturer Kaleo re-released Auvi-Q last week, an electronic epinephrine auto-injector with voice instruction, at an AWP of $2,700/auto-injector, a significant price increase from its original cost. When Auvi-Q was originally approved in 2012, it was priced at $289 per two auto-injectors, similar to pricing of Epipen and Adrenaclick at the time. In 2015, Auvi-Q was voluntarily removed from the market due to potential inaccurate drug dosage delivery, which may have included failure to deliver drug.

CVS Health recently announced that its pharmacies would make the generic version of Adrenaclick available at the highly discounted price of $109.99/two-pen package for customers paying cash or for customers in the deductible phase of their benefit.

MedImpact has been working on behalf of clients to control costs in this class. Prior to the release of the authorized generic for EpiPen, MedImpact secured aggressive rebates that sheltered clients from the significant price hikes. MedImpact added EpiPen to its Preventive Drug List, which allows for low copays on medications for members enrolled in high-deductible health plans.

There are currently a total of three, non-interchangeable, branded agents on the market: EpiPen, Adrenaclick and Auvi-Q, available in two strengths, 0.3mg and 0.15mg auto-injectors. EpiPen and Adrenaclick both have authorized generic products available. Now that generic products are available, MedImpact is following a generic strategy in this class, and has MAC pricing on the brand and generic products for EpiPen and Adrenaclick.

Product Cost/Dose Commercial Formulary Placement and UM

Auvi-Q (epinephrine)

0.15mg, 0.3mg auto-injector

AWP = $2,700/syringe (all strengths)

Broad Formulary: Non-formulary,  

Step Therapy Requires trial of EpiPen AND Adrenaclick

Quantity Limit: 2 injectors/365 days


Exclusion Formulary: Excluded

Adrenaclick (epinephrine, generic for EpiPen)

0.15mg, 0.3mg auto-injector


Broad and Exclusion Formularies:

Generic tier

EpiPen (epinephrine)

0.15mg, 0.3mg auto-injector

MAC Broad and Exclusion Formularies: Generic tier


MedImpact will continue to evaluate the market, market trends and product cost to ensure we are providing our clients and their members the low-net cost option for this class of products.



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