Payers Shun High-Priced EpiPen Competitor Auvi-Q

In light of Kaléo’s recent announcement that its high-priced epinephrine autoinjector would return to the United States market, payers from leading insurance providers are refusing to cover the emergency medication.

Auvi-Q (epinephrine injection, USP; Kaléo) has a list price of $4500 for a two-pack—substantially higher than the EpiPen’s (epinephrine injection, USP; Mylan) backlash-inducing $600 price tag. The catch is that Kaléo plans to provide the product at no out-of-pocket cost for commercially insured patients, and instead will pass the total cost of the Auvi-Q onto insurance plans.

“We met with patients and physicians and listened to the very real challenges in the current healthcare environment with obtaining access to affordable medicines,” Spencer Williamson, president and CEO of Kaléo, said in a press release. “As a result, starting February 14, for more than 200 million Americans with commercial insurance, including those with high-deductible plans, the out-of-pocket cost for Auvi-Q will be $0.”

Kaléo also vowed that Auvi-Q will be made available to costumers without commercial insurance, with a household income of less than $100,000 per-year, free of charge. The company also stated that patients who fall outside of these criteria can purchase Auvi-Q for $360.

However, leading payers are not buying into Kaléo’s pricing strategy. FiercePharma reported that Cigna, Humana, and Aetna are refusing to cover the drug. A spokesperson for Express Scripts told FiercePharma that Kaléo’s strategy is "another egregious pricing scheme that will attempt to gouge payers and damage our health care system."

During a conference call, Mr Spencer stated that multiple insurers have signed on to cover the drug; however, the company has yet to release the names of any insurers participating in coverage.

Auvi-Q was voluntarily recalled in 2015 after issues with improper dosing arose.

“The most important price is the price to the patient,” Mr Spencer said on the conference call.

Unfortunately, pharmacy benefit managers and health insurance providers have stressed that this strategy ultimately hurts consumers by hampering health care resources and bloating premiums. —David Costill