SALT LAKE CITY — Kathleen Sampson was on her deck at home in Seattle when she felt the sharp stab of a wasp. Within minutes, her throat swelled and she stopped breathing.
Her daughter — 9 years old at the time — saved her life by calling 911.
That's not the only time Sampson has had a severe allergic reaction. Now she carries an EpiPen wherever she goes.
But when the Saratoga Springs woman went to restock her supply of the lifesaving medication three months ago, she recoiled: Even though she was armed with a $100 coupon and robust health insurance, a pack of two EpiPens would cost $300.
"I don't have a choice," said Sampson, who keeps a pack in her purse at all times. "I have to have one. We were lucky that we were able to afford it."
As children make their return to school this fall, families looking to stock up on the epinephrine-injecting device are balking. Across Salt Lake pharmacies, prices for an adult two-pack range between $600 and $700, even with a coupon. Nationwide, the EpiPen's wholesale price has roughly quadrupled since 2007.
"We have to have the medication," said Julie King, a Saratoga Springs mother who has been purchasing EpiPens for her daughter since she was an infant. "This is not an acne cream. This is not an optional medication. This basically keeps her from dying every single day."
King's 17-year-old daughter is so allergic to nuts that the teen has gone into anaphylaxis six times over the course of her life, most recently at a girl's camp last summer.
Each time the price for EpiPens has jumped, King has paid. But when King went to the pharmacy two months ago to stock up on EpiPens for an upcoming trip, she was quoted a price of $950. Even with a $100 coupon from the manufacturer and her insurance, the two-pack would cost $650 out of pocket, she said.
"It used to be we could get the pens basically for free, and then it was $30, then even with our insurance it was $150, and we had the hugest sticker shock this last incident," King said. "The most we've ever paid previous to this is $300, so to go from $300 to $650 with the coupon and with insurance was pretty shocking."
King said she decided not to buy the device and instead packed four EpiPens she already owns and borrowed another two from a friend.
And she said more and more families are doing the same: borrowing EpiPens. Saving EpiPens, just for a month or two past their expiration date. Or sometimes going without.
It's not a problem exclusive to families.
"I'm furious," said Dr. Peter Taillac, an emergency physician at University Hospital and medical director at the state's Bureau of Emergency Medical Services.
Taillac said EpiPens have become so expensive that many emergency response workers are turning to alternatives.
Epinephrine itself is "cheap as dirt, generic, been around a hundred years," Taillac said. It's the auto-injector device that Mylan, the pharmaceutical company, is charging for. That's why, he pointed out, the price for the child's EpiPen pack and the adult EpiPen pack are the same price, even though the adult pack contains more of the drug.
"Epinephrine is free," Taillac said. "It's the device that costs money."
Some agencies in Washington, D.C., and New York are now training their EMTs to measure and inject epinephrine manually, through a syringe. Most advanced EMTs and paramedics are already trained to do this, but volunteer EMTs — the ones who often staff small, rural agencies — are not.
Although far cheaper, the so-called "check and inject" method is also more prone to human error.
Some Utah agencies have discussed this option, according to Taillac, although none have moved forward.
Mylan has remained tight-lipped about the pricing of the EpiPen. In a statement to NBC News, the company said that prices have "changed over time to better reflect important product features and the value the product provides," and that the company has made "a significant investment to support the device over the past years."
But the EpiPen "isn't something new," said Dr. Douglas Jones, the founder of Rocky Mountain Allergy, who said any explanations given by Mylan have been unsatisfying. "Why all of a sudden is the price increasing so much?"
At his clinic, where epinephrine is purchased in bulk and doctors can deliver the drug through a syringe, he can deliver a dose for $20, Jones said. But that's not a good alternative for parents, who don't have the training.
There are other options, like Auvi-Q or the generic Adrenaclick, but those can also be pricey. Coupons are also available that usually trim about $100 off the price. And sites like GoodRX.com can help patients compare prices at local pharmacies.
But Jones acknowledged that there are few other alternatives.
King said she will eventually pay for another EpiPen pack, even though $650 is "a huge amount of money" for the family.
"That EpiPen," she said, "is the only thing between her and a coffin."
Contributing: Brianna Bodily, Sloan Schrage
Email: [email protected]