EpiPen Price Hike Hurts Iowa Medicaid Program

DES MOINES, Iowa - It's no secret the recent surge in cost for Mylan's EpiPen is hitting the pockets of families with severe allergies, but one Iowa lawmaker says it goes further, burning a hole in the taxpayer's pocket.

"Not only is it a problem for consumers and those that need the medicine, but we also came to suspect that this was costing taxpayers and Iowa's Medicaid program a lot of new dollars," said Iowa House Majority Leader Rep. Chris Hagenow (R-Windsor Heights).

Iowa's Medicaid program, funded by Iowa taxpayers, is also losing in the EpiPen price hike, according to Hagenow's findings through the Iowa Department of Human Services.

"We got information back from the Department of Human Services that indicated exactly what we suspected," he said.

In 2012, the state paid an average of $161.35 per EpiPen. That cost nearly tripled since - with the state forking over an average of $453.61 per EpiPen in 2016, according to DHS.

"Iowa's Medicaid program pays a little bit less than what the average consumer might pay, but this is still a tremendous cost increase," Hagenow said.

Cost isn't the only thing going up for EpiPens: demand is rising, with the state submitting about 3,500 EpiPen prescriptions in 2012, 5,700 in 2015, and so far in 2016, a whopping 4,700. That last number is expected to cost the state's Medicaid program $2.8 million this year.

"This is an issue for all Iowa taxpayers to be concerned about because they're footing the bill for this," Hagenow said.

An investigation could begin soon; Hagenow says he's spoken with Iowa Attorney General Tom Miller, and Iowa could be following states like West Virginia in investigating whether Mylan violated anti-trust laws and overcharged the state's Medicaid program for EpiPens. But when it comes to the topic of pharmaceutical companies charging too much for products all around, Hagenow says he views this as a separate issue.

"There really is a case, I think, made that our pharmaceutical companies are able to invest a lot into research and development," he said. "So I want to set that aside, and what we're talking about here, is this really unfair? Is this is a company that's overbilling intentionally?"

If the price surge is discovered to have been fair, Hagenow says state lawmakers may push for a solution to the Iowa Medicaid program's lack of resources as a result of the EpiPen cost in the upcoming 2017 legislative session.