EpiPen is the leading way to treat allergic reactions that are so severe that some people can’t breathe, a condition known as anaphylaxis. To do that, EpiPen (shown above) uses the drug epinephrine, delivered by a unique, patented technology that makes it easy to inject yourself during an emergency; so much so that kids can do it, too. But while a dose of the decades-old drug costs just pennies to make, the self-injectable pen is expensive—GoodRx shows that the cost of a two-pack of EpiPen or Epipen JR starts at around $600.

As children who rely on the life-saving drug return to school, some parents might need to buy multiple pens for their kids as well as for teachers and school nurses, and those expenses can add up fast. Such is the case for Tracy Bush, of Pfafftown, N.C., whose 14-year-old son relies on EpiPen for his allergies to nuts, eggs, and other foods. Bush has watched the price of EpiPen increase over the past nine years from $146 for a two-pack to more than $600. The total cost of Bush's recent prescription for three EpiPen two-packs came to $1,819.08. 

Fortunately for Bush, her insurance along with the co-pay coupon she gets through the drug's manufacturer, Mylan, covers a large portion of the costs. Still, Bush says her family's budget is hit hard by her son's medication costs, particularly around the start of the school year.

"Kids who rely on EpiPen need to have one on their person, one with their school's nurse, one or more at home, and often one with their teachers," says Bush. "At the start of the school year, we have to factor in our son's EpiPen costs with other school expenses, including supplies and clothing, making our budget extra tight." 

Consider Generic Adrenaclick

But EpiPen isn't the only epinephrine injector on the market; the authorized generic of Adrenaclick (epinephrine auto-injector), is a cheaper option—we found it for $142 at Walmart and Sam’s Club using a coupon from GoodRx. While generic Adrenaclick isn't the same technology and is used differently than EpiPen, both auto-injectors contain the same drug, epinephrine, available in the same dosages, says Barbara Young, Pharm.D., of the American Society of Health-System Pharmacists.

“The key concern for using different epinephrine products is that patients may not be aware of differences in how you use the injector,” says Young. Each injector requires a different set of instructions, so people might use them incorrectly. That could delay treatment or even cause an injury during an emergency, she notes. 

To prevent that, Young says to make sure you know how to properly use it before leaving the pharmacy—and consider scheduling a training session. That’s because people with a history of anaphylaxis who have been prescribed epinephrine forget how to use the injector after about three months and need frequent retraining, according to a 2012 American College of Allergy, Asthma, and Immunology study. 

EpiPen Costs on the Rise

The Bushes aren’t alone in the price hikes they’re facing with EpiPen. "The past several years have seen an astronomical increase in the cost of self-injectable epinephrine," says Andrew Murphy, M.D., a board-certified allergist at the Asthma, Allergy and Sinus Center in West Chester, Penn. "This is a very real problem."

Since Mylan purchased EpiPen in 2007, the price of the drug has increased by more than 400 percent, according to DRX, a healthcare-data-comparison firm based in Los Angeles. Since then, the company has poured billions into a marketing campaign to make EpiPen a household name. Julie Knell, a spokeswoman from Mylan, told us the company attributes the price increase to changes in the healthcare "insurance landscape" as more and more people enroll in high deductible health plans. "This change to the industry is not an easy challenge to address, but we recognize the need and are committed to working with customers and payers to find solutions to meet the needs of the patients and families we serve," Knell says.

High prices are one of the most common reasons people who need the life-saving drug go without it, according to a 2014 study published in the Annals of Allergy, Asthma, and Immunology.

Currently, Mylan offers a coupon that reduces co-pays for insured patients by up to $100 per prescription (for up to a maximum of three two-pack cartons per prescription). Patients without insurance can apply to get EpiPens for free through Mylan’s patient assistance program.

Getting a cheaper Epipen

The DIY Syringe Method

To further cut costs, some have turned to using manual syringes and buying vials of epinephrine to fill them. The drug costs a few dollars per vial. But experts caution that switching to a do-it-yourself syringe is more complicated and can result in getting too much or little epinephrine. What’s more, you’ll need to be trained by a doctor or pharmacist on how to inject the drug quickly and accurately before attempting to try it during an emergency. 

And because there are different concentrations on the market, getting the proper dose is critical, especially for children. Work with your pharmacist to get the right amount of the drug. One more hiccup: You’ll need to replace the syringe and epinephrine every few months because studies show the drug loses potency after just three months. (It’s recommended that you replace EpiPens and generic Adrenaclick pens every 12 to 18 months.)

"While switching to a needle and syringe is not ideal,” says allergist Murphy, “it may be the only choice some patients have."

Editor's Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).