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Report: Medicare EpiPen Spending Up 1,100%
As the cost of EpiPens rose dramatically, so too did the number of prescriptions written for patients in Medicare, sending spending by the program skyrocketing nearly 1,100% from 2007 to 2014, according to a report from the Kaiser Family Foundation.
During the same period, the total number of Medicare beneficiaries using EpiPens jumped 164%, from nearly 80,000 users in 2007 to more than 211,000 in 2014, according to the analysis. While the report does not delve into what’s behind the increase, factors could include increased awareness among people with allergies, marketing efforts, and access to insurance coverage.
The abrupt rise is notable because many people think that life-threatening allergies are less common among the elderly. In addition, epinephrine—the active ingredient in EpiPens—can pose greater risks to older adults. FDA labeling urges caution when prescribing epinephrine to this age group. The drug’s adverse effects can include chest pain, a rapid increase in blood pressure, and arrhythmias.
The new study comes amid ongoing scrutiny of EpiPen price increases. On September 21, Mylan CEO Heather Bresch testified before the House Committee on Oversight and Government Reform. During the hearing, lawmakers blasted her company’s EpiPen price hikes as “sickening,” “disgusting,” and showing “blatant disrespect” for American families who can no longer afford the life-saving device for children susceptible to severe allergic reactions. They also noted Bresch’s $18 million salary.
The cost for an EpiPen two-pack has climbed from approximately $94 in January 2007 to $609 in May of this year. In response to criticism of its price increase, Mylan announced in late August that it would make a generic version and price it at half of its current brand-name price. The epinephrine in each EpiPen is worth about a dollar.
The new numbers from Medicare could add fuel to the debate over these price increases and to voters’ demands that Congress take action to roll back the cost of the popular medication.
Although Medicare is generally thought of as a government health program for older people, approximately 16%—9.1 million beneficiaries—are younger than 65. They are generally disabled or have kidney problems requiring dialysis. The study found that although most EpiPen users were older than age 65, a disproportionate share (35%) were younger than 65. In addition, 26% were between 65 and 69 years of age. EpiPen use fell off with age, with only 15% of the users ages 75 to 85.
Since Medicare drug plans cover part of enrollees’ total drug costs, beneficiaries in prescription drug plans pay less than the full retail price. But beneficiaries still paid significantly more of their own money for EpiPens during the seven-year period studied in the report. Average out-of-pocket spending for beneficiaries with Medicare drug coverage nearly doubled for each EpiPen, from $30 to $56. The report does not include price increases beyond 2014.
Sources: Kaiser Health News; September 22, 2016; Kaiser Family Foundation; September 20, 2016; and Reuters; September 22, 2016.