The rising price of Mylan’s EpiPen is redirecting interest toward low-cost alternatives for the emergency allergy treatment.

Editor’s note — This article discusses the growing population of individuals needing auto-injecting emergency allergy treatment, in relation to the rising cost of the medication. It includes information from the Food Allergy Research and Education organization, Centers for Disease Control and Prevention and local health professionals.

The rising price of Mylan’s EpiPen is redirecting interest toward low-cost alternatives for the emergency allergy treatment.

The 15 million people with severe allergies worldwide still worry about their safety in an emergency, and the population is on the rise.

In 2013, the Centers for Disease Control and Prevention reported a 50 percent increase in food allergies among children between 1997 and 2011. Eight foods account for 90 percent of all food-allergic reactions — milk, eggs, peanuts, tree nuts, wheat, soy, fish and shellfish.

With a growing population of allergic patients, health professionals are looking for options to make sure individuals have access to life-saving devices. However, the cost for the EpiPen has skyrocketed 500 percent in recent years.

The cost stems from the administering mechanism, not the cost of the drug. Epinephrine is relatively cheap — 25 single dose vials costs about $50 — but the EpiPen mechanism is patented.

The alternative generic on the market since 2013, labeled as “epinephrine auto-injector,” is the small competitor Adrenaclick, owned by Impax Laboratories in Hayward, California. Although the Adrenaclick brand is no longer produced, market share for the generic version has grown from about 4 percent this year to around 7 percent.

While the EpiPen sells for over $600 a pair, the rival device goes for around $200. Both products also offer manufacturer’s coupons that can bring the cost down for consumers. Mylan recently promised to launch a lower-cost generic EpiPen in the coming weeks that is identical to the brand-name device but with a list price of $300 for a two-pack.

Lauri Loder, a registered nurse with Family Practice Associates of McPherson, explained that these devices are necessary for any patient undergoing immunotherapy.

“We see EpiPens on a daily basis because all our immunotherapy patients are required to bring them in themselves when they received their allergy shot. It's protocol that they bring them because they could have a reaction at any time once administered,” Loder explained. “If a patient for some reason forgets their pen, our office is supplied with single dose vials or ampules of epinephrine to administer in case of an anaphylactic reaction. In all my years of administering these shots, I have never had to give epinephrine. In fact, in all of my nursing career, the only time I had to administer an EpiPen was to my sister. All the same, that was pretty quick, efficient and effective in the time of an emergency.”

The issue is that EpiPens are much faster and more effective than a syringe administered by the patient. Drawing up the correct dosage is time consuming and life threatening, depending on the situation.

On the other hand, both the EpiPen and the generic Adrenaclick administer a pre-measured dose of epinephrine to counteract severe allergies to bee stings, peanuts and other foods. To use an EpiPen, you remove one cap, while Adrenaclick has two covers, so there’s an extra step and the small risk of poking yourself with Adrenaclick’s exposed needle after administering it.

Food allergy is the leading cause of anaphylaxis outside the hospital setting, according to the Food Allergy Research and Education organization. Every three minutes, a food allergy reaction sends someone to the emergency department, which is about 200,000 emergency department visits per year, and every six minutes, the reaction is one of anaphylaxis.

With rising costs, some individuals with severe allergies may choose to not purchase an auto-injector pen and risk real danger.

“I don't think there are any safe alternatives to for carrying around an injectable when you have an allergy to something. Everyone is different when they have a reaction and kids should carry pens because you never know what they’ll run into,” Loder explained. “The patient who is severely allergic to bee stings or peanuts should be able to go to the pharmacy and obtain an EpiPen, regardless of if they have insurance for an affordable cost. The fact that the cost of the EpiPen from Mylan has risen to greater that $600 should be illegal. Even patients with mild reactions should be able to get one — each time a patient has a reaction to an allergen the reaction could get worse each time it happens. For instance, a bee sting on a person could have a local reaction of red, raised and swelling and nothing else. The next time it happens, the person could become short of breath and with their throat closing. You never know how your body is going to react and that is why it is best to be prepared for an anaphylactic reaction, in the form of an auto-injector pen. I don't think there really is an alternative — you either buy it or you don't or can’t.”