A bill that seeks to lower the cost for Coloradans who need epinephrine auto-injectors has been introduced in the General Assembly.

Epinephrine, best known under the brand name EpiPen, is a life-saving medication used to counter the effects of a severe allergic reaction.

House Bill 1002, sponsored by Democratic Reps. Javier Mabrey of Denver and Iman Jodeh of Aurora in the House and by Sen. Dylan Roberts, D-Eagle, in the Senate, caps the cost of a two-pack to $60. Currently, the cost for the brand name product is $690 per pen. A generic brand is about half that.

The bill is already drawing opposition from the health insurance community, and raising eyebrows because of Mabrey’s ties to its main backer. 

The issue of escalating costs for injectors gained public attention in 2016, when pharmaceutical company Mylan hiked the cost for the EpiPen. Over a seven-year period, the cost for a two-pack reportedly increased from $103.50 in 2009 to more than $608.61 in 2016.

Heather Bresch, the CEO of Mylan whose father is U.S. Sen. Joe Manchin, was called before Congress to answer questions about the price hike. Lawsuits followed over what was alleged to be price-gouging and a settlement was reached last year.

But the price is still beyond what many can afford, advocates of the proposal say.

The new program envisioned under HB 1002 would be open to Colorado residents who have prescriptions for an injector and aren’t already enrolled in a prescription drug program that already caps the cost.

Under the bill, manufacturers of the injector would be required to cover the difference between a pharmacy’s cost for the injector and the co-pay. Manufacturers that refuse to participate can be fined as much as $10,000 per month.

Mabrey told Colorado Politics companies do business here will be subject to the fines he envisions in the bill – even if they aren’t based in Colorado,

The program would be similar to one the General Assembly set up in 2019 on insulin.

Those who want to take advantage of the lower prices would fill out an application, developed by the Division of Insurance. Both the division and the Colorado Department of Health Care Policy and Financing would make that application available on their websites, and application forms could also be obtained from pharmacies, health-care providers and health facilities that prescribe or dispense the injectors.

Those who apply for the program who present those documents to the pharmacy or other dispensary in order to obtain the injectors at the lower cost. 

Lawmakers, primarily Democrats, over the past four years have worked to chip away at health care costs, mostly on two legs of a three-legged stool.

Health insurance premiums and hospital costs have been the two legs that have seen the most legislative action in, including through legislation on out-of-network billing, reinsurance and the state-designed health insurance plan, know as the Colorado Option.

Lawmakers been slower to take on the third leg – the cost of prescription drugs. The solutions so far have been to set up a prescription drug affordability review board, which drew a big fight from Big Pharma two years ago and hasn’t yet gone into full implementation.

The other effort is a law that allows the importation of high cost drugs from Canada.

As to the cost of prescription drugs within Colorado, Democratic lawmakers, through the 2019 bill, capped the cost for insulin to $100 for a 30-day supply. That measure that drew strong opposition from health insurers, CVS and the pharmaceutical industry.

Roberts was a sponsor of that measure. Along with Jodeh, he also sponsored the Colorado Option bill in 2021. 

HB 1002 is the brainchild of the Community Economic Defense Project, previously known as the COVID-19 Eviction Defense Project 

The organization hired the lobbying firm Strategies 360 to lobby on behalf of the bill. But the bill has another ace in the hold: Mabrey is CEDP’s staff attorney.

That tie has raised a few questions in the state Capitol.

When asked about a hypothetical situation and not about Mabrey’s specific bill, the legislature’s attorneys pointed to a 2006 advisory opinion from the General Assembly’s ethics board on lawmakers who have ties to nonprofits, aside from being a director.

The opinion said a lawmaker would not be in violation if they did not have an economic or financial interest in the nonprofit. 

HB 1002 has been assigned to the House Health & Insurance Committee but does not yet have a hearing date scheduled.