Some families gearing up for the start of school have noticed that one important item for kids with severe food allergies has gotten a lot more expensive.
With some retailers now charging more than $700 for a set of EpiPens, allergists say they've heard from some concerned parents. The marker-sized injectors are filled with epinephrine to stop an anaphylactic reaction.
That's several hundred dollars more than what EpiPen sets cost a few years ago, doctors said. Patients pay differing amounts depending on their out-of-pocket insurance requirements. Maryland's Medicaid program covers the drug, state health officials said.
"People use them all the time," said Dr. Jonathan Matz from LifeBridge Health Allergy and Immunology. "It's not something trivial. Most need at least one during childhood."
Up to 6 percent of children have a food allergy that could be life threatening, according to the U.S. Centers for Disease Control and Prevention.
EpiPens are frequently used for allergies to various foods, such as peanuts or shellfish, which can trigger anaphylaxis, a serious allergic reaction that usually occurs quickly and can lead to death. Symptoms are an itchy rash, swelling of the tongue or throat, shortness of breath, vomiting, lightheadedness and low blood pressure.
Allergies to insect bites or stings, or to certain medications or latex also can trigger anaphylaxis.
Prices for many drugs have shot up in recent years, as manufacturers stop making some medications.
Last year Sanofi US recalled its epinephrine injector Auvi‑Q because of inaccurate dosing. The injectors were the main competition for EpiPens, made by Amsterdam-based Mylan. A generic isn't widely available, according to allergists.
The high price for EpiPens has drawn public ire. It also has caught the attention of lawmakers who have been looking into drug pricing, including U.S. Rep. Elijah Cummings, a Baltimore Democrat and ranking member on the House Committee on Oversight and Government Reform.
"It's unconscionable that Mylan is taking advantage of a group of people who desperately need their medication to prevent life threatening allergic reactions, but I can't say that I am surprised," Cummings said.
"I'm committed to protecting my constituents and American families across the country from these abusive price increases and ensuring that they have access to the life-saving drugs they need."
Mylan said it offers patients coupons to help cover co-pays, assistance to those without insurance and some free doses to schools. In Maryland and most other states, schools are required to carry injectable epinephrine for students, some of whom may not realize they have a life-threatening allergy.
More than 900 episodes of severe allergic reaction occurred in 5,700 U.S. schools in the 2013-2014 academic year, or more than one in every 10 schools, on average, according to a survey conducted for Mylan. About 75 percent were treated with injectors. Half of the injectors were provided through Mylan's school program
"Given the unpredictable and life-threatening nature of anaphylaxis, nothing is more costly than failed or no treatment," the company said in a statement. "As such, ensuring access to epinephrine — the only first-line treatment — is a core part of our mission."
The company did not respond to questions about the retail price increase.
Dr. Alvin Sanico, director of the Asthma Sinus Allergy Program at Greater Baltimore Medical Center, said most EpiPens are not used before they expire each year because of good allergy management. He suggests "pooling resources" so that children with allergies can share EpiPen sets.
Sanico said EpiPens have been expensive for years, but he discovered recently during a round of calls to large pharmacies that sets are now going for more than $730. When they go unused, it makes the situation "even more difficult to swallow," he said.
"Logistically it makes more sense to have just a few," he said. "If 95 out of 100 expire, maybe you don't need 100 in the school nurse's office. Maybe they institute a system when they have at least four?"
To avoid allergic reactions and the need for EpiPens, Dr. Cary Sennett, president and CEO of the Asthma and Allergy Foundation of America, said the group's website offers resources, such as community forums, recipes and other advice.