Biotech and Pharma

EpiPen prescriptions increase despite spotlight on price hikes, but market share drops

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Price hikes? What price hikes?

Prescriptions for EpiPens are up briskly for 2016 — and saw even higher prescription rates in the past two months despite public outrage erupting during the same time period over price increases for Mylan's lifesaving, anti-allergy devices, new data show.

However, this report also reveals that for the first time in three years, EpiPen's market share of prescriptions for auto-injector devices for the drug epinephrine dropped markedly in September, as competitors saw growth. That decline for EpiPen came in the month after criticism of Mylan's price hikes began heating up.

The findings come from Athenahealth, a provider of online services to doctors and hospitals, which analyzed prescription data from 970 health providers.

"Despite media uproar, prescriptions for EpiPen have only grown," Athenahealth said in a report on the data released Tuesday.

The increase raises the question of whether heightened media attention on EpiPen — even though it was overwhelmingly negative — actually drove sales because more people became aware of the threat of potentially fatal allergic reactions, and took precautions against them.

"It's a good hypothesis," said Josh Gray, vice president at Athenahealth, who heads the company's Athenaresearch team, when asked if that was possible. "Parents are likely paying more attention to anaphylaxis and allergies in general this year than last due to increased media attention."

Athenahealth said it did the analysis because of the flood of news stories that began in mid-August about Mylan increasing the price of EpiPen to more than $600 for a two-pack, and the resultant criticism from consumers and members of Congress.

"We wondered whether there had been any changes in the volume of EpiPen prescriptions on athenaNet," the company said, referring to its online community where doctors can upload and share information.

Mylan has raised the price of EpiPen more than 500 percent in recent years in a series of hikes. That, in turn, increased the financial strain on a number of people with allergies, or their parents, who often buy multiple sets of the auto-injectors to have at home, school, their workplace or car in the event they develop the dangerous allergic reaction known as anaphylaxis.

But prescriptions for EpiPen continued to grow at a healthy clip, with the volume rising 14 percent year to date, Athenahealth said.

And in August and September, volume spiked 26 percent compared with the same two months last year, according to Athenahealth's data. August traditionally has the biggest volume of EpiPen sales, as parents of children with allergies stock up on the devices for the coming school year.

But EpiPen, which as a rule makes up about 95 percent of the epinephrine auto-injector prescriptions each month, saw its market share dip in September, according to Athenahealth.

EpiPen's market share went from 95.7 percent in August to 92.1 percent in September, the company said. That means the market share of competing auto-injectors nearly doubled in September, from 4.3 percent to 7.9 percent.

Athenahealth said that prescriptions for alternatives to EpiPens are up 26 percent year to date. Alternatives include Adrenaclick, which is made by Amedra Pharmaceuticals, as well for products labeled "epinephrine auto-injectors," according to Athenahealth.

"Most alternative prescriptions are for the auto-injectors; we are seeing very few Adrenaclick prescriptions on the network," said Gray.

The drug price comparison site GoodRx on Monday showed that a two-pack of Andrenaclick was selling, at a cash price, between $494 at Kroger Pharmacy and $404 at CVS pharmacies in Target Stores. But after a free coupon, the price for Adrenaclick at both of those locations, as well as at several other pharmacy retailers, was around $350 or so.

In contrast, a two-pack of EpiPens, which had a list price of more than $725 at both Kroger and Target, sold for $616 at Kroger and almost $631 at Target after a free coupon available through GoodRx.