Spring has Sprung! Where's my Epipen?!

March 23, 2017

Epipens have been in the news a lot lately, so I thought I'd update folks on how a few of the carriers in Washington state cover EpiPen options in 2017.  I may even have good news for you!

 

The wholesale pharmacy price can range from $390 - $4,800 for 2 pens (OmedaRx 2017). And when you need to have an EpiPen at school, at home, in the car, and at work, that can add up quickly - especially if you have multiple people in your family who need them.

 

OmedaRx recently published a quick reference document about EpiPen.  They are the pharmacy benefits manager for Regence, BridgeSpan and Asuris .  If you get your insurance from one of these carriers, this document is a very helpful resource.

 

OmedaRX Quick Reference:  Epinephrine Coverage

 

The authorized generic EpiPen by Mylan normally wholesales for $390 - $450 at pharmacies.  The reference guide states "As an authorized generic, the product is expected to be identical to the brand with the same device and active ingredients." OmedaRX categorizes it at the preferred generic benefit tier, and that means it will have the lowest costshare payments (for non-HSA plans).

 

So what does that mean?  For these three carriers, the cost of the EpiPens should be no more than $20 if you have a non-HSA plan.  And if you go to their preferred pharmacy, Walgreens, your copay should be even lower due to a $5 discount.

 

So what if you have an HSA plan?  Well, then it's not such a good deal - HSA plans require you to meet your deductible before coverage kicks in - and with a $2500 - $6000 deductible, you may be on the hook for a lot of money, even though there is a generic option available.  You may want to consider your options when open enrollment rolls around this fall.

 

What about other insurance carriers - well, your mileage may vary.  Call your provider to ask whether epinephrine has generic options on their formulary.

 

 

 

 

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