- Major healthcare insurers and pharmacy benefit managers (PBMs) are not happy with Kaléo Pharma after the company revealed it set a list price of $4,500 for a two-pack of its alternative to Mylan's epinephrine auto-injector EpiPen.
- Kaléo revealed a complex pricing plan for the product, Auvi-Q, in a Jan. 19 statement. The plan holds that consumers who have commercial insurance or who make less than $100,000 annually will pay nothing out-of-pocket for the two-pack of injectors. Those without government or commercial insurance who make more than $100,000 annually will pay $360 out-of-pocket.
- The real controversy came during a presentation that accompanied the statement, in which Kaléo disclosed the list price, or the starting point of what the company is looking to charge payers, for Auvi-Q. Many of those entities have already decided against covering or paying for the injectors, opting instead to stick with generic versions of Mylan's EpiPen or Impax Pharmaceuticals' Adrenaclick.
Express Scripts, Cigna and Humana stated they have no plans to partner with Kaléo on Auvi-Q, according to a report from The Street. Other big PBMs and insurers, including CVS Healthcare, UnitedHealth Group and Anthem did not immediately respond to BioPharma Dive requests for comment.
Healthcare payer Aetna, however, said in an email it "will treat the re-entrance of AuviQ as a new drug into the market, as with any other new drug," and "will be placing in a restricted coverage level until a final formulary coverage is determined."
Aetna additionally noted, "With the generic to both EpiPen and the generic to Adrenclick at Tier 1, as well as brand-name EpiPen at tier 2/Preferred coverage, we have cost-effective alternatives available for our members."
Formerly partnered with Sanofi, Auvi-Q injectors were taken off the market in late 2015 due to "inaccurate dosage delivery, which may include failure to deliver drug," according to a statement from Sanofi.
Epinephrine auto-injectors have been at the forefront of the drug pricing controversy that has plagued the pharmaceutical industry in recent months. Mylan, the maker of EpiPen, has taken heat raising the price of a two-pack of EpiPens from less than $100 in 2007 to $600 most recently. In response, the company is selling a generic version at half the cost and has offered discounts for uninsured patients.