After blitzing Mylan, Klobuchar targets Kaléo's pricey Auvi-Q, 700% jack-up on opioid antidote

Despite Kaléo’s attempts to brand its $4,500 Auvi-Q relaunch as a positive for consumers, the small drugmaker hasn’t made itself popular with payers and lawmakers. Now, an influential senator is pressing Kaléo with fresh pricing questions—and not just about its EpiPen rival.

Sen. Amy Klobuchar, D-Minn., has demanded more information about the Richmond, Virginia-based company's strategy on the epinephrine injector Auvi-Q—aimed at taking on EpiPen after Mylan's price-hike scandal—and on a lifesaving opioid overdose drug whose price has skyrocketed in recent years.

Featuring a list price several times higher than EpiPen, Auvi-Q is set for a relaunch this month after a recall forced the product off the market in October 2015. Kaléo is asking for $4,500 for a two-pack, but it has laid out a significant patient assistance program to make sure patients don’t pay anywhere near the full price.

Related: Payers block Kaléo's expensive EpiPen challenger

For its part, Mylan attracted unwanted attention last fall for its repeated price hikes on EpiPen, eventually taking the original med's list price to about $600 for a two-pack. Though discounts and rebates cut the costs for payers, consumers were forced to shell out co-insurance based on the list price, or, for those in high-deductible insurance plans, the full retail price. Sen. Klobuchar called for an investigation early into that controversy.

Now, the Minnesota senator wants to know not only why Kaléo has set such an enormous list price on Auvi-Q, but also why it increased the price of Evzio, a naloxone device to treat opioid overdoses, by 700% in three years. Klobuchar said other new EpiPen rivals have priced epinephrine injectors between $100 and $300 and are offering “generous rebates.”

In response to its EpiPen pricing firestorm, Mylan rolled out an authorized generic for about $300 for a two-pack. CVS introduced a two-pack epinephrine injector option for $109.99.

Considering the new competition from Auvi-Q, one analyst predicted Mylan’s EpiPen sales will fall from $1.1 billion in 2016 to $300 million in 2018. But Bernstein’s Ronny Gal made that statement before Kaléo unveiled its pricing strategy. He said Mylan CEO Heather Bresch “needs to send some flowers” as her company stood to gain from Kaléo’s strategy.

Shortly after Kaléo announced its Auvi-Q list price, multiple insurers and PBMs told FiercePharma that they were not paying for the drug.

Cigna said it has “no plans” to add the product to its list of covered meds, while Humana said it’s “not supportive” of the strategy. Aetna placed Auvi-Q on a “restricted coverage level until a final formulary coverage is determined.”

Not mincing words, an Express Scripts spokesperson said Kaléo’s move is "another egregious pricing scheme that will attempt to gouge payers and damage our healthcare system."

Kaléo CEO Spencer Williamson had previously told reporters that the company secured coverage from multiple insurers. He said he believes the list will “continue to grow.”

Sen. Klobuchar has frequently kept an eye on the pharma industry. Aside from her EpiPen involvement, she’s offered to help President Donald Trump on drug prices and has introduced bills that would allow Medicare price negotiations and help generics to market.