Indiana college students share history, fears with EpiPen prices

Editor's Note: The following is part of a class project originally initiated in the classroom of Ball State University professor Adam Kuban in fall 2021. Kuban continued the project this spring semester, challenging his students to find sustainability efforts in the Muncie area and pitch their ideas to Deanna Watson, editor of The Star Press, Journal & Courier and Pal-Item. This spring, stories related to health care will be featured.

MUNCIE, Ind. — Mike Bierly, a Ball State University senior, bought his first EpiPen one year ago after he was stung by a group of yellowjackets.

As an avid hiker and outdoorsmen, he didn’t want to chance having an anaphylactic reaction like he had then.

“Not only was I swollen outside on my body, but my throat was starting to close,” Bierly said. “I had to go to the doctor, and it was such a minimal level that they didn’t do anything. … I ended up getting an EpiPen after that just in case I got stung again. I didn’t want it to increase in terms of swelling in the throat.”

Bierly said he went to the doctor early, which is why his reaction was at a “minimal level.”

One year ago, Bierly said a two-pack of EpiPens cost about $50 for him to purchase. Now, it could cost around $650 if he needed a new one.

“I was on my parents’ insurance at the time, but I’m not anymore,” he said. “Honestly, it’s scary — I don’t have $600 to get (another EpiPen). So, it feels like it’s just these two last-ditch efforts.”

According to the EpiPen website, the device is “an auto-injector that contains epinephrine,” which is a medication that decreases allergic reaction by decreasing muscles in airways, relaxing rapid decrease in blood pressure, and relaxing muscles in the stomach, intestines and bladder.

The website also adds that EpiPens are for emergency treatment only and do not replace going to the hospital.

Mylan is the main manufacturer of EpiPens, according to Harvard Health Publishing, which allows them to continue increasing the price. Competitors have made similar products, but none of the products have been successful so far.

One similar product is Auvi-Q, which was pulled from the market because of concerns that the device did not deliver the correct medicine dosage. Other alternatives have not received FDA approval yet.

Bierly said he thinks other college students feel the same way about EpiPen prices, and he’s scared that he’ll have to purchase one without insurance.

“It’s sad,” Bierly said. “This is something that’s very important to my lifestyle and my general living, and I know it’s important to others as well, but it’s not economically accessible to all of us.”

Using an EpiPen for a shellfish allergy

Cassie Oliva, a junior at Ball State, said she also bought an EpiPen a year ago after she had an allergic reaction to shellfish. She said she has never had to use the device, but she likes having one just in case.

“I didn’t want something to happen, and I didn’t want to have to go to the hospital if I could have done something to prevent it,” Oliva said.

To get the EpiPen, Oliva said she went to her doctor, who had known about her shellfish allergy. After that, she said the process “was pretty easy,” and her doctor wrote a prescription for her to pick it up.

Oliva also said her parents’ insurance covered the full cost, and she doesn’t worry about it covering the cost in the future. Even when she doesn’t have her parents’ insurance, she believes she will be able to get her own through work.

“I feel like it all depends on my insurance,” she said. “I feel like that’s something I’m not going to worry about too much as long as I have some type of insurance.”

Facing the cost of an EpiPen on 'my own insurance'

While his parents still have insurance, Ball State junior Haines Hoag is nevertheless worried about the increase in EpiPen prices, especially as he gets closer to graduating and looking for a job.

“I’ll probably be able to get my own insurance,” he said, “but I am still worried and definitely understand why other people feel that way. It’s hard for some people to get them and use them, especially if you don’t have help to back you up.”

Hoag had to get an EpiPen after he was mowing the lawn and ran over a hornets’ nest last June. He said he was stung by about eight hornets and was originally feeling OK, but his lips and throat started to swell.

His dad drove him to Urgent Care, and once he arrived, he started to feel dizzy and his heart rate dropped, so the doctor put an EpiPen in him, and he went to the emergency room.

“It was definitely scary,” Hoag said, “but after that, I don’t leave my house without my EpiPen.”

Even with his parents’ insurance, Hoag said his EpiPen costs about $200.

“I haven’t had to use it yet,” he added. “If I had to use it, I would definitely be stressing out right after because I know they are a lot of money.”

Hoag also said his doctor told him that his EpiPen expires after one year, so even though he hasn’t used his yet, he is going to have to buy a new one soon.

The shelf life of an EpiPen

EpiPens expire so quickly due to the instability of epinephrine, which breaks down when exposed to light, air and high temperatures. The devices can still be used when expired, but they are not as effective.

“It’s kind of set up so that people have to keep buying them or else they’re not going to be safe if they have an anaphylactic reaction that might kill them,” he said.

Hoag also believes that because EpiPen prices are so high, he is more cautious about using his.

“I think that’s a problem with a lot of medicine,” he said. “We want to be incentivized to use it if you need it, but when you distort it with all these economic factors, you have people who need it who can’t get it. This is actually causing harm to people.”

While Bierly, Oliva and Hoag all want EpiPen prices decreased, they don’t know the best way for that to happen if there is only one credible manufacturer.

“The same thing has happened with EpiPens where the prices go up two or three times,” Hoag said. “I think all we can really do is talk to our representatives and try to get things passed that may put a limit on stuff. So, that way, regular people can afford these things they may need to keep them safe.”

This article originally appeared on Muncie Star Press: Indiana college students share history, fears with EpiPen prices