E

piPen may be a budget buster for some households, but new data indicates prescriptions for the allergy emergency device are outpacing last year’s figures. At the same time, though, more prescriptions were written recently for lower-cost alternatives and, as a result, last month marked the first time in three years that EpiPen’s share of prescriptions for such devices fell.

The number of prescriptions written for the auto-injector in August rose 19 percent from the same month a year ago. Overall, the number of prescriptions are up 14 percent through September, compared with the same period in 2015. In fact, there were 40 percent more prescriptions written in the first nine months of this year compared with 2013, even as the price for EpiPen was rising, according to Athenahealth, which provides technology services to physicians.

“I think most people just didn’t want to gamble with a potential life-threatening situation and it looks like they were willing to absorb price increases (for EpiPen) if they have to,” said Josh Gray, vice president of research at Athenahealth. The company reviewed more than 78,000 prescriptions written by 970 doctors for EpiPen and alternatives between 2013 and 2016. The prescriptions were given to more than 48,000 patients during that time.

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The growth in prescriptions occurred even amid controversy over the cost of EpiPen. Mylan Pharmaceutical raised the price by 548 percent over the past decade to $608 for a two-pack device. But as insurers passed along more of the cost, consumers confronted bigger bills. And this year, many families did so just in time for the start of the school season, which generated nationwide protest.

The large number of prescriptions may actually reflect the publicity surrounding EpiPen. Although much of the media attention has been negative, the stories may also have prompted some people to check if their existing supplies had expired and needed to be replenished. Still other people may have been moved to seek the device anyway, since it is used for potentially fatal allergic reactions.

Simultaneously, though, the company found that prescriptions for lower-cost alternatives also jumped. The only option currently approved by regulators is Adrenaclick, which can cost $400 to $450 in cash at some retailers, according to GoodRx.com, but reportedly sells for as little as $140 at some stores, if using a coupon.

As a result, EpiPen’s share of prescriptions fell from nearly 96 percent to 92 percent from August to September as more patients apparently pushed their doctors for an affordable option. Put another way, the share of prescriptions that was written for an alternative stood at 8 percent last month, up from about 4 percent in August.

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Although these alternatives comprised just 5 percent of all prescriptions written, the number of prescription written for these devices was up 26 percent so far this year compared with the same period last year. Nonetheless, Athena rightly notes that “it is still unclear whether this is the start of a shift towards alternative prescriptions or not.”

Natalia Bronshtein/STAT Source: Elsevier Clinical Solutions’ Gold Standard Drug Database

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  • What Mylan has successfully done is grow the market for epinephrine auto injectors. This is more important than market share because of the increased competition. Much to her critics chagrin Heather Bresch’s (negative) publicity became the rising tide that lifted all boats.

    • So, why wasn’t increasing unit sales of a high profit product enough?

      Why did the CEO decide that doubling profits wasn’t good enough, but profits needed to be increased by 4 times, 8 times, 20 times, 1000 times?

      A decade ago, the product was sold a little above cost, at a low price, with low sales volume. Today the sales volume is a hundred times and the profits per unit a hundred times, but lots of marketing costs consume that profit per unit, but still, instead of being quite profitable at a few million, a profit margin Walmart would love, the product has profits in the billions, but with no added value to any consumers, just more costs, more taxes to pay for those profits.

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