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Comment by invaliddata | Hacker News Reader

The adrenaclick generic is much cheaper than the epipen, with or without insurance. Although technically different epinephrine auto injectors cannot be substituted (you can only be prescribed the one written by your doctor, or its generic equivalent), practically speaking the only difference between the epipen and the adrenaclick design is the instructions for use. I would hope there isn't a case of doctors being unaware of the alternatives.

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My doctor/pharmacy was apparently unaware of the differences or neglected to inform me. At some point in the last 4 years I started getting generic Adrenaclicks instead of EpiPens. The difference between EpiPens and generic Andrenaclicks was never presented to me as a different choice in medications, just an "expensive brand name" vs "cheap generic" choice. I wonder who screwed that one up.

I did notice the different usage directions (mainly two safety caps with the generic vs one for the EpiPen) but never thought that the FDA considered them to not be equivalents. At least I made sure to carefully read the administration instructions and have trained with dummy, training auto-injectors and expired, real auto-injectors!

It's your doctor's fault if you didn't get the substitute earlier. As adrenaclick and epipen are not actually equivalent (even though ultimately they deliver the same medicine, in the same dose, in the same manner), the pharmacist is not supposed to do anything but provide what was prescribed.

Thank you for mentioning adrenaclick. Generics have been completely missing from the public debate. While epipen price gouging is very real, and a problem, there is one short term solution for allergy sufferers: demand an Rx for the generic. They are under $200 (source: checkyourmeds.com). Vote with your wallet!!

Looks like the differences are: extra safety cap and Epipen brand has an auto-retracting needle.

https://m.youtube.com/watch?v=LRgqwgCh4Fs

Great business to be in, attach an auto injection mechanism to maybe $5 worth of syringe and epinephrine.

Then undercut your competition by over 60%. I hope they do well. If more generic manufacturers get in on this or the patent expires we might see this go down to a more reasonable <$50 price, but this is definitely a step in the right direction.

Unfortunately there is no generic for Epipen. Unless you have been written a prescription for Adrenaclick specifically, you can't get it, or the generic version.

I don't understand why a prepackaged vial/syringe kit isn't readily available for epinephrine. It works just fine for glucagon...

http://www.childrenwithdiabetes.com/d_0n_022.htm

We're literally talking about $1 worth of epinephrine, a $0.50 syringe, and a couple cents worth of injection molded plastic case...

Probably because that is not what matters. With the epipen, I can just jam it into my daughters thigh, straight through thick winter clothing and all. I don't need to ensure she gets the dosage right, nor that the syringe doesn't break.

My point is that with a very slight increase in the complexity of the process, you could have a _dramatic_ reduction in cost.

New York State is actually in the process of transitioning EMTs from EpiPens to vial/syringe kits.

EMTs are not the target customer of epipens. They work with life-threatening situations day after day. To a kindergarten teacher, if a child if having an anaphylactic chock, this is very far from a "very slight increase in complexity".

Just to ground the situation, the kindergarten teachers at my daughters place are already freaked out from the thought of having to administer an epipen. I can't even start to imagine how they would handle a syringe and a bottle.

There are thousands of people out there who carry IM Glucagon kits, an similarly time sensitive medication, intended to be administered by untrained bystanders. If it works for Glucagon, I see no reason it can't work for Epinephrine. In reality, there's no need for a vial, the syringe can be prefilled with the correct dose.

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