By Brad Tuttle
July 7, 2016
Stuart Dunn—Getty Images/iStockphoto

Though EpiPens are hardly the only prescription medications subjected to insane price hikes lately, they easily rank among the most exasperating health expenses that families face.

Last year, more than 3.6 million Americans received prescriptions for EpiPen, an epinephrine auto-inject system that can potentially save the life of someone suffering from an allergic reaction. A disproportionally high percentage of those in need of EpiPens are children, and they typically need multiple packs of them—to leave at school or camp in addition to one for parents to carry around.

While all prescription medications are useful, the EpiPen belongs in a special category of severe necessity: It’s not used to ease pain or make patients more comfortable or functional; it’s literally a lifesaver.

Everyone knows that allergy sufferers could die without an EpiPen handy. Yet more and more people are finding it difficult to get their prescriptions filled because they are so insanely expensive. The retail price of an EpiPen pack, which comes in sets of two, is up over $600, compared to around $100 a decade ago. Most patients need at least two packs, and the average American family today has a high-deductible insurance plan, so that means they’re out more than $1,200 this year.

Because EpiPens expire in one year, a new prescription must be filled annually. Based on how swiftly prices have risen, in a year’s time, it’ll surely cost even more to get a new EpiPen pack. Compounding the frustration is the fact that allergy sufferers will pay tens of thousands of dollars over the years for a tool that they hope they never, ever have to use.

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As Stat News reported this week, some allergy sufferers are going to extraordinary—and dangerous—lengths as an alternative to paying through the nose for EpiPens. They are using manual syringes and epinephrine, which cost a total of about $20 at the pharmacy. An allergist in South Florida told Stat News that roughly one out of every six of his patients now chooses syringes over EpiPens to save money. One mom quoted in the story said she was pursuing this option after facing a $1,200+ bill for her son’s EpiPens. “I don’t even pay that much for my mortgage,” she said.

The syringe alternative is no simple solution, however. “Anyone using this approach would require extensive medical training to do it effectively and safely, without contamination or accidental intravenous injection,” said Dr. James Baker, Jr., the CEO of Food Allergy Research & Education (FARE), a nonprofit that lists Mylan, which manufactures the EpiPen, as its top corporate sponsor.

When MONEY previously reached out to FARE about EpiPen prices, the organization released this statement attributed to Baker: “FARE acknowledges that manufacturers, insurers, pharmacy benefit managers, regulators and retailers are involved in the path to market, and ultimately the cost and pricing of epinephrine. We strongly encourage transparency regarding pricing and access and welcome meaningful discussions on this issue across the food allergy marketplace in the interest of identifying sustainable and affordable solutions that truly provide appropriate access to all in need.”

FARE also provides tips for filing an appeal with insurance companies to get your EpiPen prescriptions covered, and for finding out about coupons and other programs to lower prescription costs paid out of pocket.

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Still, what’s frustrating—and again, potentially life-threatening—for families is the knowledge that it’s no trouble for people in other parts of the world to get EpiPens affordably. As we’ve previously reported, anyone can get an EpiPen prescription filled in Canada, for four or five times less than what it costs in the U.S.

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