SAN FRANCISCO (KPIX 5) — Kaiser Permanente is making changes following our reports it was rationing the lifesaving EpiPen by only giving patients half of their prescription – one syringe instead of the usual two.
We also revealed that the HMO was making double the money off each prescription. Kaiser patients said they were charged a second co-payment when they came back to get the other half of their prescription.
Regulators announced they were investigating complaints about Kaiser’s new policy following our reports. Now Kaiser says it is changing its policy.
In a statement Wednesday night Kaiser said, in part: “Effective immediately, we will collect a co-pay only when the second of the two pens from a prescription is dispensed; members will not be charged a co-pay when they receive the initial, single pen.”
Kaiser says it will also issue refunds to people who already paid twice.
However, Kaiser also says it will continue rationing the generic version of the epinephrine injector that it covers for patients. In most cases, Kaiser says it will only allow patients one pen per prescription.
Manufacturers only make epinephrine injectors in a two-pack box because the first pen may misfire. In addition, many people need two doses to survive and that is how the FDA approved the medication.
Regulators say a pharmacist must fill a full prescription as prescribed by the doctor. But, as we revealed, Kaiser is splitting lifesaving epinephrine prescriptions and giving patients one syringe even when their doctors prescribe two.
Some patients also complained that Kaiser gave them a single EpiPen without a prescription label, which would be a violation of state law, according to regulators.
While Kaiser says it’s rationing due to a shortage of the version of the EpiPen it normally covers for patients, many point out that there is no shortage of the Auvi-Q brand epinephrine injector.
Because Kaiser is an HMO – the doctor, insurer and pharmacy – patients say it’s been difficult to get Auvi-Q. They need a specific prescription from the Kaiser doctor.
Kaiser own policy says it will cover Auvi-Q during a shortage of other brands.
Following Kaiser’s change of policy on co-pays, we asked if the HMO would now also consider covering Auvi-Q brand injectors for patients who want a full prescription.
Kaiser told us that Auvi-Q charges them nearly $5,000 per prescription compared to the $200 Kaiser pays for the brand it currently covers. It also noted that Auvi-Q requires patients use a specific pharmacy so they could not fill a Auvi-Q prescription at a Kaiser pharmacy.
In a statement Kaiser said: “Auvi-Q has set this up to be a limited distribution drug that requires the patient to complete a form for access and be filled by mail through a specific pharmacy. Despite this, Kaiser Permanente does not have restrictions on our physicians prescribing Auvi-Q devices.”
Kaiser says it will allow its doctors to write prescriptions for Auvi-Q so patients can get the medication directly from the manufacturer.
Auvi-Q is offering anyone with commercial insurance a $0 co-payment. However, it is a little more work to get Auvi-Q. Patients must download the form from the Auvi-Q website and bring it into their doctor to fill out.