Amid a shortage of EpiPens, Deerfield-based Walgreens is partnering with a competing drugmaker to make it easier for consumers across the country to get its devices.
Auvi-Qs – devices used to inject epinephrine to counter severe allergic reactions – are available for the first time at Walgreens stores nationwide. Before, consumers seeking Auvi-Qs got them mostly through the mail.
A two-pack of the devices has a wholesale price of $4,900, according to Elsevier’s Gold Standard Drug Database, but the devices will be free to most consumers. Drugmaker Kaleo will cover any out-of-pocket costs for people with private insurance, regardless of whether their insurance agrees to cover the medication.
If a consumer’s insurance company agrees to cover the product, the consumer can get it at Walgreens and Kaleo will cover any deductible or copay costs. If a person’s insurance doesn’t cover the product, Walgreens will reach out to Kaleo’s hub of specialty pharmacies, which will mail the devices to the customer’s home, Kaleo President and CEO Spencer Williamson said.
The companies partnered “to try to address this supply shortage,” especially now, during back-to-school season, which is when a majority of epinephrine prescriptions are filled, Williamson said.
“There’s been a lot of awareness around the epinephrine shortage, and it’s a very important lifesaving medication, so we really wanted to be innovative and partner with someone to help improve the accessibility for the medication,” said Nicole Leiter, a corporate operations vice president with Walgreens.
The most popular type of epinephrine auto-injector, the EpiPen, has been in short supply for months, sending some parents and patients scrambling.
The U.S. Food and Drug Administration added EpiPens and a similar epinephrine auto-injector made by Impax Laboratories to its drug shortage list in May. The EpiPen shortage is due to “manufacturing constraints” at the Pfizer subsidiary that makes the device, according to the FDA.
Pfizer recently extended the expiration dates of many of EpiPens to try to ease the shortage, and the drugmaker has said it expects supplies to stabilize in the fourth quarter of this year. The FDA also recently granted another company approval for a generic EpiPen.
Auvi-Qs perform the same function as EpiPens but are shaped differently and play audio that walks users through the process of delivering injections.
The list price of Auvi-Q is much higher than that of EpiPens, which can cost as much as $600 for a two-pack, according to Elsevier.
Williamson said Kaleo set the Auvi-Q’s price where it did because many large insurers refused to cover it at the same level as other similar products when the company reintroduced the device in 2017. Kaleo had to set the price at a certain level so it could give the auto-injectors for free to the many consumers whose insurance plans wouldn’t cover it, he said.
“That’s how we provide access to all patients,” Williamson said.
It’s a tactic that has drawn criticism from some, including Sen. Chuck Grassley, R-Iowa, who last year wrote in a letter to Williamson, “Your pricing structure may simply shift the burden and cost to another entity within the health care system.”
Michael Carrier, a professor at Rutgers University Law School, said it’s a particularly aggressive strategy for getting a product into patients’ hands.
“It shows how our health care system is broken, the fact that some entities are paying $5,000 and some are getting it for free,” Carrier said.
Walgreens customers will generally need prescriptions for Auvi-Qs from their doctors to get the devices, Leiter said. If a customer has a prescription for a different auto-injector that’s out of stock, Walgreens can reach out the customer’s doctor to see if a prescription for a different device can be written, she said.
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