For many parents, an Epicene Auto Injector is something they hopefully will carry around in their purses, backpacks or pockets and never ever have to use on their children.
And, year after year, they hope to reach the prescription’s expire date without incident and go ahead and refill the life-saving medication.
Aliza Goldgewert of Teaneck has carried an EpiPen for her 12½-year-old son since he was 2, and, blessedly, has never had to use.
“We have to get a pack for school and one for home,” she told the Jewish Link. “You hope to throw them out unused. But, God forbid, if you ever need them, you have them.”
EpiPen is an epinephrine injector that is used in the treatment of severe allergic reactions. The medicine prevents anaphylaxis, which may be caused by the eating of certain foods, insect stings and bites, medication allergies and even latex allergies.
The epinephrine is injected into a person’s outer thigh, even through their clothing. And as one school nurse told the Jewish Link, “Yes, it is going to hurt, but with that pain comes the saving of a life.”
EpiPen has been in the focus of business and health news lately because of a steady rise in its pricing. In 2007, a twin-pack retailed for approximately $94. That has reached a high of $608 this year. There are coupons that can reduce the price, and insurance plans that don’t require the higher-end costs. Still, that hasn’t stopped public opinion about Mylan Pharmaceuticals, the manufacturer of EpiPen, or of its CEO Heather Bresch.
Indeed, the CEO, whose salary has increased 671 percent since 2007 to $19 million annually, was called last week to the House Committee on Oversight and Government Reform where she received a bi-partisan chastisement.
“I think many people incorrectly assume that we make $600 off of each EpiPen,” she told the committee. “This is simply not true.” Bresch added that the company earns about $100 per twin pack.
On Monday, however, the Wall Street Journal reported that Bresch delivered inaccurate information to the committee that Mylan’s profits on the EpiPen were at about 60 percent.
Locally, Rep. Scott Garrett (R-NJ-5) joined several other members of Congress calling on the Food and Drug Administration to express “concerns over the near monopoly currently held by Mylan Pharmaceuticals on the EpiPen.
The letter to the FDA asked if there were any barriers existing to prevent the approval of EpiPen alternatives.
For Tenafly Pediatrics pediatrician Dr. Robert Jawetz, is not uncommon for him to write more EpiPen prescriptions during the back-to-school season in late summer and early fall, and prior to the opening of summer camp.
“I haven’t had anyone complain to me about the price since the story broke,” said Dr. Jawetz. “I have had people ask me about cheaper options. But most of my patients have some sort of insurance or co-pays or discount cards that reduces the price. I knew that the EpiPen was expensive, but I had no idea it went up to $600.”
There was an alternative medication called the Auvi-Q, which was taken off the market last year because of a problem with inaccurate dosages.
“For a child or an adult who has an allergy to anything that could progress to anaphylaxis and has no access to epinephrine, it could potentially be a death sentence,” said Dr. Jawetz. “I’ve heard too many stories of older kids who go into a restaurant and a teenager orders chili, but doesn’t know there’s peanut butter in the chili.”
The physician said that this scenario is always possible, and that people with food allergies always need to ask if there are nut products in foods.
Goldgewert said her family hasn’t been impacted in any way by the recently reported EpiPen cost hikes.
“Apparently there is a sweet spot,” she said, “where insurance companies negotiate their contracts with pharmaceutical companies. If you are in a sweet spot, your company has not yet renegotiated costs. We paid zero. The manufacturer provides a $100 coupon, so it came to zero. We happen to be at the right point in the contract. There are two times a year we refill the prescription. My son goes to sleepaway camp, so he brings the EpiPen home and we use that as our home EpiPen. Before the school year starts, we refill.”
Miriam Rosenfeld, of Bergenfield, has two family members who carry the EpiPen, her 4-year-old child and her husband.
She called it a “rough reality” in the potential of sticking a needle through her child’s clothes into the thigh muscle, but as she was quick to add, “Thank God we have the EpiPen.
“Unfortunately,” Rosenfeld added, “a lot of kids have allergies these days. People need to be sensitive about them. Schools need to be aware and peanut free. People also need to be aware that there are other allergens. I think of this when I hear people complain that they can’t bring a peanut butter and jelly sandwich to camp or a granola bar. But people need to think beyond themselves.”
Like Goldgewert, Rosenfeld also has a coupon that gives her a $0 co-pay. Still, she thinks the complaints about the costs should be more measured.
“All meds cost a lot,” she said. “People get up in arms about the EpiPen. But these are allergies; these aren’t diseases that are transmitted. People don’t get up in arms of the hiking of costs of HIV meds. I think people should be more fair. It’s part of capitalism and we have to deal with it.”
Phil Jacobs
