New York law mandates EpiPen coverage by insurers, limits out-of-pocket costs

Authored by 13wham.com and submitted by plz-let-me-in
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Gov. Kathy Hochul has signed a new law aimed at reducing the high costs of epinephrine auto-injectors, commonly known as EpiPens, for consumers with commercial health insurance. The legislation mandates health insurers cover EpiPens and caps out-of-pocket expenses at $100, making the essential treatment more affordable for New Yorkers with severe allergies.

"For people with severe allergies, immediate access to an EpiPen device can mean the difference between life and death," Hochul said in a statement. "When every second counts, the last thing New Yorkers should have to worry about is whether they can afford the medication they need to survive an anaphylactic reaction. By signing this bill, we are putting people over profit and giving New Yorkers peace of mind by ensuring equitable access to this lifesaving emergency treatment."

EpiPen devices are crucial for treating life-threatening allergic reactions, known as anaphylaxis, which can be triggered by insect bites, foods, medications and other causes. The cost of EpiPens has surged dramatically, with prices increasing by 600% since 2007. While they once cost $60 per device, they can now sell for over $600 for a two-pack. EpiPens have a short shelf life, expiring after about 12 months, necessitating frequent repurchases.

The new legislation, S.7114-A/A.6425-A, requires health insurers in both individual and group markets, including non-profit insurers and HMOs, to cover medically necessary EpiPens for emergency allergic reactions and limit annual out-of-pocket costs to $100. This move is expected to alleviate the financial burden on those who rely on these devices for their health and safety.

StingingBum on December 13rd, 2024 at 17:53 UTC »

"For people with severe allergies, immediate access to an EpiPen device can mean the difference between life and death," Hochul said in a statement. "When every second counts, the last thing New Yorkers should have to worry about is whether they can afford the medication they need to survive an anaphylactic reaction. By signing this bill, we are putting people over profit and giving New Yorkers peace of mind by ensuring equitable access to this lifesaving emergency treatment."

plz-let-me-in on December 13rd, 2024 at 17:37 UTC »

Gov. Kathy Hochul has signed a new law aimed at reducing the high costs of epinephrine auto-injectors, commonly known as EpiPens, for consumers with commercial health insurance. The legislation mandates health insurers cover EpiPens and caps out-of-pocket expenses at $100, making the essential treatment more affordable for New Yorkers with severe allergies.

I couldn't find the exact number of states that require health insurance to cover EpiPens, but it wasn't until 2019 when Illinois became the first state to require health insurance companies to cover EpiPens, so this actually happened pretty recently.

Here are some more details about the insane cost of EpiPens and the greed of big pharmaceutical companies:

Few prescription drugs or devices symbolize out-of-control health care costs more than EpiPen.

From 2008 to 2016, Mylan pharmaceutical company raised the price of its auto-injectors by more than 400%, leading to public outrage and congressional scrutiny.

“We encourage Big Pharma to end their price gouging tactics and lower their out-of-control prices for patients,” the group said in a statement to NBC News. “Patients need their life-saving medications, so a lack of medication choices mean that Big Pharma has no incentive to agree to lower prices.”

blazelet on December 13rd, 2024 at 17:33 UTC »

The fact we have to pass laws like this, state by state, years and decades after these medications passed the point of unaffordability, for individual medications is just asinine.

I lived in the states for 35 years. When I left my Insulin cost $350 a vial. In Canada I can buy the same vial over the counter for $35 without even needing to show an ID. There are national solutions to this problem, the US leadership is choosing not to embrace them.