Health care plans keep allergy rescue injectors expensive for some

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By By Ellie Quinlan Houghtaling HealthDay Reporter, health day reporter

(Health Day)

FRIDAY, July 15, 2022 (HealthDay News) — Although there are now more choices for emergency allergy injectors like EpiPens, the cost is still proving prohibitive for some, according to new research.

Even though most people are saving money with cheaper alternatives after the cost of EpiPens skyrocketed a few years ago, a significant minority of users — people with high deductibles on their health insurance — are paying always too expensive.

“Our results suggest that the availability of lower-cost competitors has not solved the affordability problem for all patients who use epinephrine auto-injectors, particularly those covered by plans that require deductible payments and coinsurance for drugs,” said the study’s lead author Dr. Kao-Ping Chua. He is a pediatrician and health policy researcher at Michigan Medicine/University of Michigan.

The study looked at 2015-2019 data for more than 657,000 children and adults via the IBM MarketScan business database, which contains claims data for 28 million Americans with employer-sponsored insurance. .

The researchers’ previous work on this topic, published in 2017, analyzed how much US private policyholders paid annually for the EpiPen between 2007 and 2014. During that time, EpiPens were the only major epinephrine auto-injector available. on the market. Unsurprisingly, the study authors found that out-of-pocket spending on the EpiPen doubled over this period, largely because the list price of the product tripled.

But the new study focused on data from the introduction of new EpiPens competitors. Between 2015 and 2019, cheaper generics like Adrenaclick and Teva hit the market.

The authors found that average annual spending on auto-injectors peaked in 2016 at $116, but began to decline as patients switched to cheaper competitors. In 2019, annual out-of-pocket expenses fell to $76, and 60% of patients paid $20 or less for auto-injectors.

But even by the end of those years, 1 in 13 patients were still paying more than $200 for the drug. Of these patients, 62.5% were enrolled in high-deductible health plans. These popular plans cover about 30% of privately insured Americans.

More than 63% of patients paying more than $200 a year were children, which the researchers say could be because children typically need twice the amount of medication as adults because they have it. need at home and at school.

“Our study shows that patients can still pay dearly even if they use less expensive epinephrine auto-injectors. To improve affordability for these patients, insurers could consider capping the cost of unbranded auto-injectors,” Chua said in a university press release. “Alternatively, the federal government could consider a federal cap similar to the one currently under discussion for insulin.”

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

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

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