CVS, Cigna Decisions Encourage Use of Cheaper EpiPen Alternatives

Shortly after Cigna announced it would stop covering the name-brand EpiPen, CVS declared it would begin selling a cheaper generic version of the costly epinephrine injector. Earlier in the week, Heather Bresch, CEO of the EpiPen manufacturer Mylan, had reflected on the controversy surrounding the device’s price.

The bad news for EpiPen sales began on Wednesday, when the EpiPen was removed from Cigna’s coverage list. The insurer will instead cover the authorized generic version of the device that halts life-threatening allergic reactions. Mylan announced the launch of the generic in December 2016, touting its list price of $300 per 2-pack of injectors, representing a discount of more than 50% off that of the name-brand EpiPen.

Cigna issued a statement explaining its decision to revise its covered drug list in hopes that it would “encourage use of the generic version as it will deliver more overall value to customers and clients.” The generic, it said, “has the same drug formulation and device functionality as the branded medication, but at a substantial cost savings.”

On Thursday, CVS Health announced that all of its pharmacies would now sell the authorized generic of Adrenaclick, an epinephrine auto-injector made by Impax Laboratories. A 2-pack of that device costs patients $109.99, which CVS said was the lowest cash price on the market. According to the press statement, the decision was made as the pharmacy “recognized the urgent need for a less-expensive epinephrine auto-injector” after the brand-name devices became “increasingly expensive.”

The price of a 2-pack of EpiPens surpassed $600 in 2016, sparking a national furor that Mylan CEO Heather Bresch addressed in an interview with CNBC at the annual JP Morgan Health Care Conference on Tuesday. Bresch said the controversy “absolutely has made Mylan a stronger company” and made her “a stronger leader.” She reiterated her empathy for patients, vowing to help change pharmaceutical pricing to be seen through the “patient lens.”

Bresch was not concerned about potential criticism from President-elect Donald J. Trump, who has repeatedly attacked drugmakers like Mylan that rapidly raise prices. Trump “appears to be someone who appreciates very decisive and immediate action,” she said in the interview, citing Mylan’s development of the generic injector and its distribution of $300 rebate cards for the full-price product as examples of such decisive actions to make its drugs more affordable.

Mylan stock was down 4.3% when markets closed on Wednesday, leading investors to wonder whether the drop was in response to the Cigna coverage decision or was part of industry-wide fallout from comments made by Trump in a Wednesday news conference when he said pharmaceutical companies were “getting away with murder.”