EpiPens and Adrenaclicks

If Bernie Sanders had tried to shop around a little, which is a thing that people do in free-market economies, he would see that there is a cheaper generic called Adrenaclick.

Granted, a duopoly between Amedra Pharmaceuticals and Mylan is not the ideal market. But at $142, Adrenaclick is less than a quarter of the price of EpiPen. Why are so many people bitching about Mylan when they can vote with their dollars instead?

One mealy-mouthed excuse is that Adrenaclick is harder to use, and that most people are trained on EpiPens.

Who are these people? I would imagine that the allergy patients who carry auto-injectors on their person at all times (as recommended by Mylan paid spokesperson Sarah Jessica Parker) are trained in whatever they choose to carry.

Even if these patients are depending on a second responder, the instructions are printed ON THE CASE. For both products. Not that it matters, because the steps are practically the same. Just watch the training videos: EpiPen vs Adrenaclick

The videos are very boring and no one’s gonna watch them, so here’s a spoiler: The ONLY discernable difference is that Adrenaclick requires that the user remove two end caps before administration, whereas EpiPen only has one cap. I suppose this could be confusing for a person who can neither read, nor comprehend number labels, nor follow the cartoon drawings on the package. But I don’t know what subset of the population that might be.


A better explanation for why we’re vilifying Mylan is that doctors don’t know a competitor exists. A professor of pediatrics who writes for The NYTimes says of Adrenaclick: “few physicians think of it.”

This sounds like a terrible failing on the part of the medical physicians. Doctors are supposed to be aware of the drugs available to treat their patients. It’s part of their job description. It’s also why state medical boards require medical doctors fulfill some minimum number of hours of continuing medical education (CME) every year. In California, the minimum requirement is 50 hours of education every two years.

The purpose of CME is to make sure physicians have up-to-date knowledge of medical developments. CME requirements can be met through activities like coursework, manuscript review, or by attending conferences SUCH AS THIS ONE SPONSORED BY MYLAN, in which participants listen to educational things like this presentation about patients forgetting how to use their EpiPens.

The conferences might be educational in nature, but they also involve lavish dinners and parties. If I were a doctor (which I most definitely am not, therefore nothing here is medical advice), I, too, might conveniently forget about EpiPen’s cheaper competitor after a sponsored trip to Orlando.

The health care industry is full of unofficial kickbacks and sort-of conflicts-of-interest. Sometimes there’s nothing a patient can do about it, but this is not one of those times. GoodRx is a site for comparing prescription drug costs, and Adrenaclick is the first result that appears in a search for generic epinephrine. GoodRx is a great resource that everyone should use. And I don’t get a kickback for saying that.

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