CVS offers low-cost version of EpiPen; experts say more options expected

PharmacyFor families managing life-threatening allergies, access to auto-injectable epinephrine — the medication that reverses the harmful effects of anaphylaxis, is critical.

But the price tag for the go-to prescription, EpiPen, a product manufactured by Pennsylvania-based Mylan, Inc., has skyrocketed in recent years, hitting a record high of $649 for a two-pack. The spike has outraged parents and pediatricians, and in some cases, stunted access for those with no insurance or high-deductible plans.

But the epinephrine auto-injector landscape is starting to shift.

CVS Health announced it is offering the authorized generic Adrenaclick® for $109.99 for a two-pack — about a sixth the cost of EpiPen. The price applies to both insured and cash-paying patients without insurance.

“This is good news for families because it provides an effective but less expensive alternative to EpiPen,” says John Lee, MD, clinical director of Boston the Children’s Hospital Food Allergy Program.

For qualifying patients, the discounts don’t end there. Adrenaclick’s manufacturer, Impax Laboratories, is offering $100 off per pack, via the company’s coupon program.

About the epinephrine auto-injector

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Adrenaclick, approved by the U.S. Food & Drug Administration, provides the same medication and dosing as EpiPen and can be used safely for anaphylaxis.

There is one area of caution, Lee says. Because the Adrenaclick mechanism is slightly different, it’s important for patients, families and pediatric providers to be familiar with the product and overall use.

“Families that get the generic epinephrine auto-injector need to be aware of how to use it as the mechanisms are different from the EpiPen and Mylan’s generic version,” he says. “It’s important for anyone taking care of a child with food allergies to be trained on how to use Adrenaclick.”

Looking to the future

Lee expects to see more epinephrine auto-injectors enter the market this year, including a heat-stable device produced by Massachusetts-based Windgap Medical, Inc. The product is expected to be smaller than EpiPen (about the size of a lighter) and eliminate the shelf-life problems associated with liquid epinephrine.

Auvi-Q, a product voluntarily recalled in October 2015 due to potential inaccurate dosage delivery, is also expected to re-enter the growing pipeline. “Auvi-Q can be an attractive option for some families because it provides audioinstructions and is a smaller version that can fit in person’s pocket,” he says.


John Lee, MD, is the clinical director of the Boston Children’s Food Allergy Program, co-director of the Eosinophilic Gastrointestinal Disease (EGID) Program and Instructor in Pediatrics at Harvard Medical School.



Learn more about Boston Children’s Food Allergy Program and the upcoming Pediatric Asthma & Allergy for Primary Care Providers CME.