Pharmaceutical company Kaléo will offer an alternative epinephrine autoinjector to Mylan’s EpiPen starting in 2017, the company announced this week. The desire for such a rival is strong and widespread, as patients and lawmakers have thoroughly criticized Mylan for dramatically increasing the price of its life-saving device. But those seeking solace in the apparent greed of the pharmaceutical industry may not find it in Kaléo or its auto-injector, Auvi-Q.
Auvi-Q has been on the market before and sometimes had a higher price tag than Mylan’s EpiPen. While Auvi-Q’s 2017 pricing has yet to be determined, Kaléo’s drug pricing track record is similar to Mylan’s. In fact, in recent years, Kaléo has increased the price of a device used to reverse fatal opioid overdoses by more than 650 percent. And like Mylan, Turing, and others, Kaléo argued that customer support programs and discounts would ensure that high list prices wouldn’t impact patients — even though those high list prices could still help drive up the overall cost of health care.
In an email exchange with Ars, Mark Herzog, vice president of corporate affairs for Kaléo, declined to answer direct questions about whether the company would help drive down the high cost of epinephrine autoinjectors. Instead, Herzog noted that the company “is working to partner with various stakeholders, including wholesalers, insurance companies and pharmacy benefit administrators, to implement a comprehensive access program for Auvi-Q.” The company’s intent, he added, is that “every patient who needs an epinephrine autoinjector, regardless of insurance coverage, should have affordable access to Auvi-Q.”
Kaléo unveiled Auvi-Q in 2013, pitching it as a slick replacement for an EpiPen. Designed by twin brothers with deadly food allergies, Auvi-Q is the size of a credit card with the thickness of a slim smartphone. While EpiPens are more like chunky pens, the Auvi-Q can slip into a pocket and be carried discreetly. Also unlike EpiPen, Auvi-Q has a voice prompt system that calmly guides users through the adrenaline injection, which is typically a hectic process to stop a life-threatening allergic reaction.
Kaléo brought Auvi-Q to market by licensing it to Sanofi, a pharmaceutical giant with marketing talent. At the time of its debut in 2013, the list price of an Auvi-Q two-pack was about $200, which was in line with the price of Mylan’s EpiPen two-packs at the time. By early 2015, Auvi-Q’s price had risen above $500, broadly in line with EpiPen’s price, but 10 percent higher in some areas. In fact, Mylan even cited the rising price of Auvi-Q as a factor in raising the price of EpiPens in a letter to Senator Charles E. Grassley (R-Iowa).
But in October 2015, Sanofi voluntarily recalled Auvi-Q after reports that the devices were not delivering accurate doses of epinephrine. Kaléo has since regained the license for Auvi-Q. The company is feverishly revamping its production process by automating production and adding more than 100 quality controls.
Meanwhile, its main competitor in the epinephrine autoinjector market, Mylan, has faced unbridled anger from patients, healthcare providers and legislators alike for continuing to raise prices. Currently, the list price of an EpiPen two-pack is $600. Unsurprisingly, Mylan’s profits and executive compensation have skyrocketed in step with the price increases.
While Kaléo now seems to have the opportunity to nobly re-market Auvi-Q at a lower price point than Mylan’s EpiPen — and Mylan’s upcoming generic version — it may not be quite as high. While Kaléo has regained a foothold on Auvi-Q, it has dramatically increased the price of another product: Evzio, an autoinjector that delivers naloxone, a cheap, decades-old drug that reverses fatal opioid overdoses. In the past two years, Kaléo raised the price of a two-pack of Evzio from $575 to $3,750. The price increases came amid a nationwide epidemic of opioid addiction and crisis-level overdoses.
Herzog defended Kaléo’s Evzio pricing, saying, “Patients and their caregivers with commercial insurance and a prescription can obtain Evzio for a cash price of $0, even if their insurance doesn’t cover Evzio or if they have a high deductible.” Herzog also noted that “the ‘list price’ is not a true net price for anyone.”