Health plans keep allergy-rescue injectors expensive for some

By Ellie Quinlan Houghtaling HealthDay Reporter, Health Day Reporter

(health day)

FRIDAY, July 15, 2022 (HealthDay News) — Though there are now more choices for lifesaving emergency allergy injectors like EpiPens, the cost still proves prohibitive for some, new research shows.

Although most people are saving money with cheaper alternatives after the cost of EpiPens skyrocketed a few years ago, a significant minority of users — those with high health insurance deductibles — are still overpaying.

“Our results suggest that the availability of lower-priced competitors has not solved the affordability problem for all patients using epinephrine auto-injectors, particularly those covered by plans that require deductibles and co-insurance payments for medications,” he said Lead author of the study, Dr Kao-Ping Chua. He is a pediatrician and health policy researcher at Michigan Medicine/University of Michigan.

The study examined 2015-2019 data from more than 657,000 children and adults through the IBM MarketScan Commercial Database, which includes claims data from 28 million Americans with employer-sponsored insurance.

The researchers’ previous work on the subject, published in 2017, analyzed the amount privately insured Americans paid for the EpiPen each year between 2007 and 2014. During this time, EpiPens were the only major epinephrine auto-injectors available on the market. Not surprisingly, the study authors found that spending on the EpiPen doubled during this period, largely because the product’s list price tripled.

But the new study focused on data from when new competitors to EpiPens were introduced. Between 2015 and 2019, cheaper generics like Adrenaclick and Teva hit the market.

The authors found that average annual deductibles for the auto-injectors peaked at $116 in 2016, but began to decline as patients switched to cheaper competitors. By 2019, annual self-expenses dropped to $76, and 60% of patients paid $20 or less for the auto-injectors.

But even at the end of those years, one in 13 patients was still paying more than $200 for the drug. Of these patients, 62.5% were enrolled in high-deductible health plans. These popular plans cover around 30% of privately insured Americans.

More than 63% of the patients paying over $200 each year were children, which researchers suggest may be because children typically need twice as much medication as adults because they take it both at home and in the office also need at school.

“Our study shows that patients can still pay a lot even when using cheaper epinephrine auto-injectors. To improve affordability for these patients, insurers might consider capping the cost of ownership of unbranded auto-injectors,” Chua said in a university press release. “Alternatively, the federal government could consider a federal cap similar to that currently under discussion for insulin.”

The results were published on July 11 in Journal of General Internal Medicine.

SOURCE: University of Michigan, press release, July 12, 2022

Copyright © 2022 Health Day. All rights reserved.

Comments are closed.