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Legislation Saving Lives: A Local Perspective

Katherine White

This week, the Nebraska Legislature’s Banking, Commerce, and Insurance Committee listened to testimonies regarding LB1094, a proposed bill aiming to limit the cost of epinephrine auto-injectors to $60 for a two-pack.

As a parent of a child with food allergies, I wholeheartedly support this bill and commend Sen. Eliot Bostar for its introduction.

The prevalence of life-threatening food allergies has been increasing steadily. Over the past two decades, the Centers for Disease Control and Prevention (CDC) reported a more than 50% rise in children with food allergies, with the number of children allergic to peanuts or tree nuts tripling.

Notably, the incidence of severe food allergies and the risk of fatal anaphylaxis are escalating at a faster pace among Latino and Asian-American children. The CDC’s data also reveals that 8% of all children have food allergies, equating to approximately two children in every classroom.

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In Nebraska, an estimated 197,282 individuals are affected by food allergies, with over 36,000 being children under 18 years old. Among them is my 16-month-old son, Tucker.

Tucker was diagnosed with life-threatening peanut and egg allergies at just 6 months old. Unfortunately, there are no known cures for such allergies, necessitating us to carry two epinephrine auto-injectors at all times. These injectors are crucial in reversing or slowing down the effects of anaphylaxis, a severe allergic reaction, before seeking emergency medical assistance.

One of the major challenges faced by food allergy patients and their families is the soaring cost of epinephrine auto-injectors. Presently, brand-name EpiPens are priced between \(650 and \)730, while generic versions range from \(320 to \)750.

Considering the injectors’ one-year shelf life and the recommendation for patients to have two sets available—one for home and one for school—it is evident that many Nebraskans are struggling to afford this life-saving medication. This issue is not new; six years ago, CNN reported a more than 400% increase in the cost of these vital devices since 2007.

As the prices of epinephrine auto-injectors continue to climb, the utilization of high-deductible health insurance plans has also surged nationally by 83.7% over the past decade.

This combination poses a significant challenge for food allergy families, particularly in Nebraska. In 2022, 65.3% of private sector employees in our state were enrolled in high-deductible health insurance plans. For a Lincoln-based food allergy family purchasing two packs of epinephrine auto-injectors annually, the out-of-pocket expense amounts to nearly \(1,400—just shy of the median monthly mortgage payment of \)1,586 in Nebraska.

This financial burden is unacceptable for nearly 200,000 families in the state who are forced to choose between paying their mortgage or affording life-saving medication for their loved ones due to circumstances beyond their control.

Unfortunately, many families opt to forgo their medication due to the high costs involved. In 2021, a survey by FARE (Food Allergy Research & Education) revealed that 91% of respondents came from households earning less than $75,000 per year. The primary reason cited for not filling or refilling epinephrine auto-injector prescriptions was the cost.

While some may argue that price caps could stifle innovation, the EpiPen has seen minimal changes over the years, and competition has not driven down prices. A report by CNBC in 2016 highlighted that the actual medication in an epinephrine auto-injector costs merely one dollar. Additionally, the San Jose Mercury News discovered that manufacturing an EpiPen costs just $8.

Illinois and Colorado were among the first states to successfully implement a price cap of $60 for a two-pack of epinephrine auto-injectors last year.

I urge others to support LB1094. Together, we can enhance the lives of nearly 200,000 families in Nebraska.

Katherine White resides in Lincoln.