
STATEHOUSE – A new law will require health insurers in Rhode Island to cover the full cost of life-saving epinephrine injectors, commonly known by the brand name EpiPen.
The legislation, approved by the General Assembly on June 16 and signed by Gov. Daniel J. McKee on June 22, is aimed at preventing costs from being an obstacle to those whose lives depend on the device, which is used to manage severe symptoms of an anaphylactic reaction such as throat swelling or difficulty breathing, according to bill sponsors Sen. Pamela J. Lauria, D-Barrington, and Rep. Michelle McGaw, D-Portsmouth.
Stay Ahead of Winter Respiratory Illnesses: Expert Advice from South County Health Express Care Providers
As winter progresses, so does the season of respiratory illnesses. Colds, the flu, RSV, and…
Learn More
“Epinephrine is an absolute necessity for anyone with a serious allergy that could result in anaphylaxis, including many children,” said McGaw, who works as a consultant pharmacist in the long-term care community. “The skyrocketing costs of these devices [are] an outrage and needs to be addressed, but in the meantime, it must not be allowed to discourage or prevent people from filling their prescription. Having epinephrine available quite literally makes the difference between life and death for a person experiencing anaphylaxis, so costs should not stand in the way for anyone.”
The new law will require private and nonprofit insurers and health maintenance organizations that provide prescription coverage to cover at least one twin pack per year of at least one type of epinephrine auto-injector and cartridges, without copayments or deductibles, for all policies issued or renewed after Jan. 1, 2025.
“As a matter of public health and safety, it’s irresponsible to allow the high costs of epinephrine to be passed on to patients because it means so many people are going without at tremendous risk to themselves or their children,” said Lauria, a nurse practitioner. “We are very grateful to our colleagues and leadership in the General Assembly for recognizing the importance of passing this legislation this year.”
The lawmakers said Mylan N.V., the manufacturer of the brand-name EpiPen, raised its price by about 500% between 2009 and 2016, resulting in average prices of more than $600 per twin pack. Even patients with prescription coverage may be saddled with high cost-sharing rates for the drug. In recent years, generic versions of the device have been developed, but they still cost $300 or more per twin pack, the lawmakers said.
The single-use injectors expire 18 months from when they are manufactured, so patients need to purchase new ones frequently regardless of whether they are ever used. Patients also need to have one available at all times, so they may need to keep several at once. Many of those at risk for anaphylaxis are children, who may be exposed to their allergen at school or through other children.