Out-of-Pocket Costs for Epinephrine Auto-Injectors Examined


FRIDAY, July 22, 2022 — Out-of-pocket spending for epinephrine auto-injectors decreased among privately insured patients in 2017, coinciding with availability of lower-priced nonbranded products, according to a report published online July 11 in the Journal of General Internal Medicine.

Kao-Ping Chua, M.D., Ph.D., from University of Michigan in Ann Arbor, and Rena M. Conti, Ph.D., from Boston University, used commercial claims to assess out-of-pocket spending on epinephrine auto-injectors between 2015 and 2019. The analysis included 657,813 patients (aged 0 to 64 years).

The researchers found that in 2015, 95.3 percent of fills were for branded products (EpiPen or Auvi-Q) versus 11.2 percent in 2019. In 2017, the year after the authorized generic of EpiPen was released, nonbranded products jumped to 58 percent from seldom used in 2015 to 2016. Mean annual out-of-pocket spending declined from $115.80 in 2016 to $75.80 in 2019. The median out-of-pocket spending per two-pack in 2019 was $736 for Auvi-Q, $63 for branded EpiPen, and $10 for each nonbranded product. For 60.9 percent of patients, annual out-of-pocket spending across epinephrine auto-injector fills in 2019 was $0 to $20, but for 7.5 percent of patients, it was >$200. The median annual number of auto-injector units dispensed was identical between these two groups of patients.

“Findings suggest patients who only use nonbranded epinephrine auto-injectors can still face substantial cost-sharing if plans employ deductibles and co-insurance in pharmacy benefits,” the authors write.

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