An effort to cap the price of epinephrine auto-injectors for Coloradans passed a major hurdle Friday, receiving unanimous approval from its first committee.

If passed by the full legislature, House Bill 1002 would require insurance companies to cap out-of-pocket costs at $60 for a two-pack of auto-injectors, better known as the trademark EpiPen.

The bill would also create the Epinephrine Auto-injector Affordability Program for uninsured Coloradans to get EpiPens at low costs.

Though EpiPens, which counter the effects of a severe allergic reaction, cost only around $8 to manufacture, a two-pack of name-brand EpiPens costs $690 without insurance, bill sponsors say – that’s up from around $90 in 2006. EpiPens also expire after 12 months, meaning they need to be re-prescribed and repurchased annually.

“People with life-threatening conditions are unable to afford their medicine due to corporate greed and their need to profit,” said bill sponsor Rep. Iman Jodeh, D-Aurora. “People are choosing between paying their rent, putting food on the table, or paying for lifesaving medication.”

The program created by the bill would allow uninsured Coloradans to apply for low-cost EpiPens online through the Colorado Division of Insurance. EpiPen manufacturers would be required to make the EpiPens available to individuals through the program, with a penalty of up to $10,000 per month if they refused to participate.

In Colorado, there are nearly 566,000 people with life-threatening food allergies. More than 101,000 of those people are minors. 

Lindsey Lewis Smithson said her 5-year-old son, Lincoln, has severe food allergies. The first time he tried peanut butter at 5 months old, Lincoln had to be taken to the emergency room. Lewis Smithson said her son turned blue, swelled beyond recognition and struggled to breathe.

“He was dying in front of me as I held him. … I watched epinephrin save his life,” Lewis Smithson said. “We have no choice. We are trapped.”

Lewis Smithson said she tries to buy generic epinephrin injectors because they’re cheaper, though they’re still around $170 per pack. But constant shortages and injectors expiring months earlier than the marked date often forces her to buy expensive name-brand EpiPens, she said. 

Kathleen Van Voorhis said she and her daughter both have severe allergies. Van Voorhis goes through three to five EpiPens per year, and her daughter goes through two to four per year. She said this averages to around $4,800 spent on EpiPens annually.

“As I sit here with you, my daughter is in the nurse’s office currently being treated for an allergic reaction,” Van Voorhis said. “This medication is literally the difference between life and death. … I urge you to consider the children and individuals who will die if we do not intervene in predatory price hikes of this lifesaving medication.”

The House Health and Insurance Committee unanimously approved the bill Friday morning, advancing it to the House Appropriations Committee for further consideration.

While lawmakers from both sides of the political aisle stood together in support of the bill, the Colorado Competitive Council, Colorado Association of Health Plans and America’s Health Insurance Plans spoke against the measure on Friday. The groups raised concerns that the bill would cause health insurance costs to increase for all Coloradans.

“Every year there are numerous bills to incrementally increase the cost of insurance to protect a particular slice of the population,” said Patrick Boyle with the Colorado Competitive Council. “While none of these separately grossly increase the cost of insurance, over the course of 20 years, we have watched as each mandate and protection has been put in place, the cost of insurance is growing.” 

The bill’s other sponsor Rep. Javier Mabrey, D-Denver, pointed to the state’s program capping copays for insulin, which HB 1002 was modeled after. Since the legislature approved the insulin cap in 2019, there has been “absolutely no evidence” that it resulted in higher insurance premiums, he said.

Regardless, the state must take action to make EpiPens affordable for those who need it, advocates of the bill argued.

Mabrey said that, while he was campaigning for the House election last year, a school nurse in his district told him they are hesitant to administer EpiPens to students because the school is forced to charge the students’ parents for the EpiPens due to the high costs.

“I deeply believe that health care is a human right,” Mabrey said. “The ability to pay for lifesaving medication should not be a barrier to access that medication.”