Mylan’s branded EpiPen dropped from Cigna coverage list

Mylan's EpiPen
Cigna is dropping Mylan's branded EpiPen product from its formulary list.

Mylan is taking another hit tied to its EpiPen pricing controversy, with Cigna now pushing patients toward the company’s new half-priced generic version or a new cheaper device from Impax Laboratories.

The first listing on Cigna’s drug changes for the year is the EpiPen, showing the new generic versions as now being covered for Cigna’s 15 million insurees. On Jan. 7, Cigna began requiring pre-authorization for coverage of the branded EpiPen treatment for allergic reactions, the Street reported.

STAT News, which also reported that a number of state medicaid programs are also moving coverage to the discounted versions of the drug. And CVS is trying to disrupt Mylan's dominance, today announcing that it now carries an authorized generic of the Adrenaclick made by Impax at a cash price of $109.99 for a two-pack, a price that compares to Mylan's generic at $399.99 and its branded EpiPen at $599.99. It even included a FAQ that tells patients how to get their prescription changed to buy the cheaper version.

A Mylan spokesperson said in an email that the "formulary changes were anticipated and are why we anticipate successful generic utilization."

While Mylan might expect these changes now that it is offering the discounted pens, it certainly didn’t expect the firestorm that led to offering the discounted versions. The controversy broke out last year in response to news reports about the continual price hikes it has taken on the product as competition fell by the wayside.

While Mylan’s pricing is not unlike what is done in both the branded and generic drug industries, Mylan has become the poster child of the price pushing that drugmakers routinely do, and suffered more of the consequences, including having Mylan CEO Heather Bresch have to defend her company before Congressional hearings.

Mylan is taking steps to counter the revenue hits that are coming, including offering EpiPens through its own pharmacy to cut out the costs of “middlemen.” It is also lobbying states for “entity prescription” legislation that would allow public places such as restaurants and parks to purchase and store EpiPens.

But just this week, Bernstein analyst Ronny Gal forecast that with more competition coming, prompted in large part by the public backlash, Mylan’s key product will reel in $300 million in 2018, down from its $1.1 billion estimate for 2016.

Editor's Note: The story was updated to include a comment from Mylan and to make clear that the generic CVS carries is not Mylan's official generic.