EpiPen alternative costs pennies in Mexico


McALLEN — A life-saving medication that costs more than $600 in the United States is only a few cents in Mexico.

EpiPen alternative costs pennies in Mexico

By NAXIELY LOPEZ Staff writer | Posted 10 hours ago

McALLEN — A life-saving medication that costs more than $600 in the United States is only a few cents in Mexico.

The EpiPen’s controversial price hike from about $100 to more than $600 in just a few years is drawing many Rio GrandeValley residents to seek relief in Mexico, where medication is easily accessible.

Nuevo Progreso is a Mexican medical destination, with tourists from near and far making the trip to the tiny border town. An array of street promoters greets tourists as they enter the country, promoting anything from Viagra to Xanax to Lipitor.

However, the EpiPen, which is used to treat extreme and possibly fatal allergic reactions, is highly sought there but is not available.

“They were thinking of bringing it to Mexico, but it’s possible that because of the cost, they couldn’t bring it,” Dr. Noel Rodriguez said. “It’s very expensive.”

Rodriguez is an allergist in Matamoros, Mexico. He is a distinguished doctor in both Mexico and the United States, and he has been in the field for more than 28 years. He met with the medical director of the EpiPen maker in 2011, when he was president of the MexicanCollege of Allergy, Asthma and Pediatric Immunology.

Mexico has strict restrictions on epinephrine, the main ingredient in EpiPens, Rodriguez said. It is only sold to hospitals, clinics and specialists like himself.

“If you go to the pharmacy, they won’t sell it to you,” he said.

Less than three percent of Rodriguez’s patients suffer from extreme allergies, but he still is able to have medication handy. For Rodriguez, a box with 50 vials of epinephrine costs him $250 pesos — or the equivalent of 25 cents per vial.

“To us, it is very abusive on behalf of pharmaceuticals and health insurances companies to sell two vials at 600 dollars — seeing as how inexpensive the vial actually is,” he said. “And it’s something that can save a person’s life.”

Rodriguez gives away the medication to patients who need it. But first, he teaches them how to properly administer it.

“Adrenaline can’t be injected whichever way because the patient can die,” he said of epinephrine, which is another term for adrenaline. “You put them in danger. What you do is instruct the patient. That’s why they don’t sell it to the public, because a medic has to instruct them how to use it.”

Each vial contains one milliliter, or the equivalent of three adult doses. It must be carried along with a syringe and injected intramuscularly in the thigh area.

“Where your pant line runs and between the knee and hip,” Rodriguez said. “That’s how it should be applied. But it’s very important to give a physical demonstration, so they can see the actual dosage in a syringe so they don’t commit any errors, because if you inject all of the dosage it could cause them heart problems, a lot of anxiety or even seizures if it’s not used correctly.”

Rodriguez advises anyone looking for an alternative to the EpiPen to do their homework.

“Its use is very delicate and should be strictly supervised by a doctor with experience with that medicine, because not every medic knows how to use adrenaline,” he said. “So it’s very important that they research and find a credible source of information.”

Rodriguez plans to keep helping patients from both sides of the border who can’t afford to buy the treatment.

“I’ve had patients that have had to utilize two weeks salary — those who work in Brownsville — to pay for it,” he said. “They’ve told me that. Can you imagine? And it costs 25 cents.”

Editor’s Note: This is a perfect argument why Reference Based Pricing makes sense. The Lower Rio Grande Valley with a U.S. population of 1.3 million, borders on Mexico. Employer based health plans pay $600 or more through PBM’s for EpiPens while the cost is much less just a five minute drive across a man made line (border). Plans should pay the Mexico price with plan participants paying the difference, if any. Reference Based Pricing can be applied to all health care, not just EpiPens. Groups who adopt Reference Based Pricing enjoy savings of 40% or more, above and beyond managed care plans (PPO’s).