Comparison of Epinephrine Auto-Injectors

by Kelley Barnett

After reading numerous articles about the high costs of epinephrine auto-injectors (EAIs), over the last two weeks especially, I decided to look into the differences and our local prices. I am especially concerned that some people do not fill or refill their EAI prescriptions due to cost, hoping they will not need it; this is very scary and a risk no one with life-threatening food allergies should take.

EAI Options

Let’s start by looking at the different EAIs on the market:

• Mylan’s EAIs, EpiPen and EpiPen Jr., have been on the market for 25+ years and they report that they are the #1 prescribed EAI. There is no FDA equivalent generic version of Mylan’s EAIs.
• Amedra Pharmeceutical’s EAI, Adrenaclick, is another option. Amedra’s customer service representative reported that Adrenaclick is no longer being produced but will be sold until they sell out.
• Adrenaclick has an approved Generic by Lineage Therapeutics. Lineage will continue to produce the Generic version. Amedra's customer service representative shared that “they are both the same and produced by the same company”. In order to receive the Generic EAI, the prescription should be written for Epinephrine injection USP auto-injector. The prescription cannot be written as a prescription for EpiPen and the "generic" box checked, since there is no approved generic of Mylan’s brand EpiPen.

Costs of EAIs in the Memphis, TN area

​I called several pharmacies, national chains and local, and inquired about their cash prices for the EAIs. This is the information I received over the phone. Please know this is not necessarily representative of your region; prices change based on area, changes from the manufacturer, and even by store location. ​Since health insurance plans vary, the pharmacies could not give me any information on cost when using insurance plans. When a patient pays cash price, it typically does not count towards their health insurance plan’s out-of-pocket deductible. Each individual/family should research all available options and choose the best one for their circumstances. 

​What I learned during the process:

• Surprisingly, some pharmacies did not know the difference between Amedra’s brand (Adrenaclick) and Lineage’s Generic.
• Walgreen’s sells a savings card that costs $25/year for an individual and $35/year for a family (price quoted over the phone for our region). It is good for 1 year and the savings depends on the prescription. This savings card can combine with manufacturer’s savings coupons as well, so you can use both the Walgreen’s and the Mylan or Lineage coupons together. Based on the cash price, I was given the following quotes over the phone for the cash price of the EAI’s: card saves $151 on EpiPenJr., saves $80 on EpiPen, and saves $100 on Generic. 
• ​You do not need a membership to use the pharmacy at Sam’s or Costco. This may vary by region.
• GoodRx offers a savings card as well as price comparison on their website. Some of our members use this savings program and shared positive experiences. One member with high-deductible insurance was quoted $697 for EpiPen, $497 for Generic but used the GoodRx coupon at a national chain pharmacy and paid $191 for Generic. 
• Other members have ordered their EAIs via mail order pharmacy using their health insurance plan. They ordered the prescription as a “3 month supply” so they received 3 sets of EAIs at one time, which saved money.
• Some people prefer one brand of EAI over another based on what the school faculty/staff or daycare employees have been trained on and feel comfortable using.​

The moral of the story is to do your research to find prices that are affordable for you and your family.

You may also find the following resources helfpul:  

• FAAM's Resource Page with links to manufacturer websites, available coupons and EAI comparisons by FARE and KFA
• ​Allergy & Asthma Network Prescription Assistance   
• GoodRX.com, some physicians may have their brochure available with information

Let your voice be heard!

If you don’t like the prices of EAIs, there is something you can DO! Contact your state’s senators and representatives. Go to your Senator's website and find the “Contact Us” link. You search for your senator and representative and will then be asked for your name and message to contact them. The process is similar to find and contact your Representative. Including your family's personal story may be helpful. If every adult in FAAM wrote a letter, our Tennessee Senators and Representatives would receive hundreds of letters. If food allergy families across the country wrote letters, hundreds of U.S. Senators and Representatives would be called to action. Change has to start somewhere!