A $3 Solution Could Solve FQHCs EpiPen Woes

Mylan’s astronomical 400% price increase of its EpiPen made national headlines bringing about public backlash and congressional scrutiny about potential price gouging of the life-saving drug used to treat severe allergic reactions. Yet, a lesser-known ramification is the budget-tightening scenario for Federally Qualified Health Centers (FQHCs), which treat underserved and underinsured patients and also need to keep an epinephrine product on hand. However, an inexpensive alternative to EpiPens is available that could save FQHCs a significant amount of money.

The current price of EpiPen, an epinephrine auto-injector, has increased to more than $600 from $94 in 2007. As the EpiPen’s price has increased, it has created a greater strain on FQHCs’ budgets, which rely on Medicare/Medicaid reimbursements, and often operate on a 1-2% profit margin.

FQHCs are required to keep epinephrine stocked on site, to immediately treat a patient experiencing a severe allergic reaction. However, health care facilities can purchase vials of epinephrine that cost $3 per 1 mL and clinicians can measure out the amount needed in an emergency situation.

FQHCs would stock EpiPens due to the convenience of a non-clinician being able to administer the product, if necessary. However, the product only has a one-year shelf life and more than 50% of the auto-injectors are disposed of because they are unused at the time of expiration and are replaced with new stock.

If a 20-facility FQHC purchases one EpiPen pack for each facility at the current $600 price, it would cost $12,000. If 50% of packs are unused by the expiration date, it would be a $6,000 loss. If the same FQHC purchased two vials of epinephrine for each facility it would cost $120 and if half of the vials went unused by the expiration date, only $60 would be lost. This is a 100-fold decrease.

In response to the steep price of EpiPens, many health care facilities and medical offices that are willing to reconsider their options in purchasing epinephrine may have an opportunity to keep the life-saving drug on site while finding significant cost savings that can be applied to other initiatives at their facilities. 

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