A bill seeking to cap the price of epinephrine auto-injectors in Colorado took a big step forward Wednesday, receiving approval from the state House of Representatives.
If passed into law, House Bill 1002 would require insurance companies to cap out-of-pocket costs at $60 for a two-pack of auto-injectors, better known as the trademark EpiPen, which counters the effects of a severe allergic reaction.
The bill would also create the Epinephrine Auto-injector Affordability Program for uninsured Coloradans to get EpiPens at low costs.
“No Coloradan should have to choose between life-saving medication and putting a roof over their head,” said bill sponsor Rep. Javier Mabrey, D-Denver. "This is a life-saving drug that Colorado families need and Colorado children need to live. ... The costs have gotten out of hand."
Though EpiPens cost around $8 to manufacture, a two-pack of name-brand EpiPens costs $690 without insurance, bill sponsors say — that’s up from around $90 in 2006. EpiPens also expire after 12 months, meaning they need to be re-prescribed and repurchased annually.
The program created by the bill would allow uninsured Coloradans to apply for low-cost EpiPens online through the Colorado Division of Insurance. EpiPen manufacturers would be required to make the EpiPens available to individuals through the program, with a penalty of up to $10,000 per month and engaging in a deceptive trade practice if they refuse to participate.
In Colorado, there are nearly 566,000 people with life-threatening food allergies. More than 101,000 of them are minors.
During a committee hearing on the bill, Colorado families reported spending up to $4,800 on EpiPens annually, requiring multiple EpiPens to be kept at home, in the car and at their child's school, among other places. Even when buying cheaper, generic epinephrin injectors, families said they still pay around $170 per pack, plus face constant shortages and early expirations of the injectors.
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“The current prices for an EpiPen two-pack are inaccessible for hardworking Coloradans, requiring nursing assistants, child care workers, and cashiers to work over 40 hours to pay for their life-saving medication,” said bill sponsor Rep. Iman Jodeh, D-Aurora.
The House voted 47-15 in support of the bill on Wednesday, advancing it to the Senate for further consideration.
All Democrats voted in support of the bill and all but four Republicans voted against it. Republican Reps. Lisa Frizell of Castle Rock, Richard Holtorf of Akron, Rick Taggart of Grand Junction and Ron Weinberg of Loveland joined their Democratic colleagues in voting "yes" on the bill.
While no lawmakers explained their opposition to the bill during the House debate, some organizations raised concerns during the committee hearing that the bill would cause health insurance costs to increase for all Coloradans.
“Every year there are numerous bills to incrementally increase the cost of insurance to protect a particular slice of the population,” said Patrick Boyle with the Colorado Competitive Council. “While none of these separately grossly increase the cost of insurance, over the course of 20 years, we have watched as each mandate and protection has been put in place, the cost of insurance is growing.”
Mabrey said the bill was modeled after the state’s program capping copays for insulin, arguing that since the legislature approved the insulin cap in 2019, there has been “absolutely no evidence” that it resulted in higher insurance premiums.
The bill will next be sent to the Senate in the coming weeks for another vote. If passed, it will need final approval from the governor before taking effect on Jan. 1, 2024.
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