EpiPen Coupons Might Save You Money, If Your Insurance Accepts Them
Last week in a move to expand access to EpiPen, Mylan upped the dollar amount of a discount coupon from $100 to $300 and expanded the number of people eligible to receive free EpiPens. While the company hasn’t budged on the cash price—still more than $600 per two-pack—the coupons could offer substantial savings for some people, although not everyone will be helped.
For Robin Bunch, of southern California, Mylan's discount coupon for EpiPen isn't helpful. Bunch carries two sets of EpiPens due to her son’s severe food allergies. When Bunch headed to the pharmacy in late August to fill her prescription for a set of EpiPens with the $300 Mylan coupon in hand, she was shocked when the pharmacist told her she still owed $350. She refused to pay it. "My husband called our health insurance plan and they told us 'Mylan has excluded your plan from using the coupon,'" Bunch said.
Bunch’s health insurance, a federally funded plan through her husband's government employer, isn't eligible for Mylan's coupon discount. People enrolled in Medicare, Medicaid, Tricare or other military plans, and any state or federally funded health plans like Bunch's are ineligible for the co-pay discount.
"If patients encounter challenges [using the coupon], we want to hear from them at our customer service line, so we can address them," Mylan spokeswoman Julie Knell told us. If you have questions, call Mylan's customer service line at 800-395-3376.
People without health insurance can't use Mylan's EpiPen co-pay coupons at all, but they might qualify for its Patient Assistance Program, which provides free EpiPens to those at 400 percent of the federal poverty level. A family of four making no more $97,200 annually would qualify.
But those with commercial insurance could see big savings, at least until December 31, 2016 (that's when Mylan's offer expires). Over the past two years, Lori Kading, of Austin, Texas, says her co-pay for an EpiPen two-pack through her health insurance was about $75. When she went to refill her prescription this week, she brought the $300 Mylan coupon with her to the pharmacy and paid zero dollars. "I went online, grabbed the coupon, and it took all of 15 minutes for the pharmacy to process the discount. It was easy."
When Coupons Work, and When They Don't
Patients who will benefit most from the coupon are those enrolled in a commercial plan that covers EpiPen. For some people whose co-pay is $300 or less, the out-of-pocket costs could be as low as $0 for three two-packs.
Until Mylan releases the generic version of EpiPen—which the company says it will do in the next several weeks, and cut the price in half to $300 for a two-pack, consider the generic version of Adrenaclick. (See chart below for when that's a good idea.) It's a lower-cost epinephrine auto-injector, and is available right now. You could get it for as low as $140 at Walmart with a coupon from GoodRx.com.
The manufacturer of generic Adrenaclick also offers discounts using a co-pay coupon—whether you're insured or not. Savings there could be as much as $100 off a co-pay or $100 off the full price if you don't have insurance. In that instance, there's a catch: You might have to pay the full amount up front if a pharmacy doesn't accept the card, then send in the receipt to be reimbursed in about two weeks.
Your Insurance | Your Best Options |
No insurance | Generic Adrenaclick. Best bet is using GoodRx.com coupon for $140 at Walmart. Apply for free EpiPens through Mylan's patient assistance program if you earn no more than $97,200 for a family of four. Process could take several weeks before you receive the free pens. |
Commercial insurance (i.e. insurance from your employer) that doesn't cover either EpiPen or generic Adrenaclick | Generic Adrenaclick. Best bet is using GoodRx.com coupon for $140 at Walmart. |
Commercial insurance with $300 or less co-pay that only covers EpiPen | EpiPen and consider Mylan's co-pay coupon to get your cost to $0. |
Commercial plan with $300 or greater co-pay that only covers EpiPen | 1. EpiPen and use Mylan's co-pay coupon and pay the difference after $300 discount. 2. If after discount are applied, and the EpiPen co-pay is still more than $140, don't use insurance and instead get generic Adrenaclick for $140 at Walmart using GoodRx.com coupon. 3. If #2 is not an option, you could still bypass insurance, get generic Adrenaclick, use its manufacturer co-pay coupon for savings of up to $100 off the retail price of about $450. |
Commercial plan that only covers generic Adrenaclick | 1. Generic Adrenaclick and use manufacturer co-pay coupon to get $100 off your co-pay. 2. In a weird twist, consider not using insurance if your Adrenaclick co-pay is still more than $140, even with a discount from a manufacturer co-pay coupon. Instead use a $140 GoodRx.com coupon at Walmart. |
Commercial insurance that covers both EpiPen and generic Adrenaclick | 1. Epipen if your co-pay is $300 or less; use co-pay coupon to get your cost to $0. 2. Generic Adrenaclick, if your co-pay is $100 or less; use manufacturer co-pay coupon to get your cost to $0. 3. Consider not using insurance if your co-pay is more than $140 for either generic Adrenaclick or EpiPen after discounts are applied. Instead, consider GoodRx.com coupon for $140 at Walmart. |
Medicare, Medicaid, Tricare or other federally funded plans | These plans are not eligible for Mylan or generic Adrenaclick discount coupons. Ask your pharmacist to price both EpiPen or generic Adrenaclick to see which is cheaper with your insurance. |
Savings Today Could Mean Higher Costs Later
Consumers have increasingly turned to co-pay coupons to help pay for their medication, as insurance companies raise both deductibles and co-pays, according to recent figures from healthcare data company IMS Health.
"At face value, consumers might think that these coupons are a good idea,” says Stephen W. Schondelmeyer, Ph.D., Pharm.D., a professor of pharmacy economics at the University of Minnesota. "But we need to step back and ask what’s going on with Mylan raising prices, and then offering discount programs to address it. The company had to raise the price so they could give you the discount."
Mylan says their coupons act as a "measure to offset the out-of-pocket cost for commercially insured patients at the pharmacy."
But discounts programs like the one offered by Mylan can, in turn, trigger insurance companies to raise prices on consumers in other ways later on—for example, in the form of higher premiums for everyone covered by a plan.
Another drawback: Co-pay coupons generally have expiration dates. The new Mylan coupon is good through December 31, 2016, after which the company will “re-evaluate the program,” said Knell.
“At best, coupons are a short-term answer to the problem of rising drug prices and unaffordability," says Joseph S. Ross, MD, MHS, an associate professor of medicine and public health at Yale School of Medicine. "The case of Epipen is akin to when there is no generic available—that’s when co-pay coupons make the most sense for patients, it at least partially mitigates the high drug cost. However, it doesn’t justify the high prices drug companies are charging."
More from Consumer Reports:
Top pick tires for 2016
Best used cars for $25,000 and less
7 best mattresses for couples
Consumer Reports has no relationship with any advertisers on this website. Copyright © 2006-2016 Consumers Union of U.S.
