This article is for epinephrine prescribers
Did you know there are cost differences between an “authorized” generic and a generic? When it comes to epinephrine auto-injectors, it can be confusing, especially with so many manufacturers. Knowing our coverage and how to write the prescription may help our members receive the lowest cost option at the pharmacy.
We've heard from members filling prescriptions that they are confused about the different products and want to know which one is covered. As a result, we updated our medication lookup tool to include manufacturer information next to the name of the product.
What’s the lowest cost option that we cover on our standard formulary?
For members who use our Blue Cross standard formulary (commercial members with a medical plan that includes pharmacy benefits or group Medex members with a three-tier pharmacy benefit), the lowest cost option is: Epinephrine auto-injector manufactured by Mylan (this is the generic for Epi-pen Jr [0.15 mg] and Epi-Pen [0.3 mg]). We cover at a limit of two pens per one copay.
Here’s an overview of our standard (Blue Cross) formulary coverage:
| Drug | Product type (manufacturer) | Coverage (for members with a 3-tier pharmacy benefit) |
|---|---|---|
| Epinephrine Auto-Inject 0.15 MG, 0.3 MG |
Generic (Mylan) | Tier 1 |
| EpiPen Auto-Injector 0.15 MG, 0.3 MG |
Brand (Mylan) | Tier 2 |
| Auvi-Q 0.1MG, 0.15MG, 0.3MG Injection |
Brand (Kaleo) | Non-covered |
| Adrenaclick 0.15MG and 0.3MG Injection |
Authorized generic (Amneal) | Non-covered |
How can you write the prescription so the pharmacy knows the lowest cost version to dispense?
To ensure the lowest cost option is filled at the pharmacy, we recommend writing the prescription as: "Epi-pen/Epi-pen Jr dispense generic pens manufactured by Mylan."
What’s the difference between a generic and an authorized generic?
Read the US Food & Drug Administrative description.
Thank you!
Thank you for helping our members fill prescriptions for the lowest cost option available.
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