A bill seeking to cap the price of epinephrine auto-injectors in Colorado passed its final legislative vote on Friday, now only needing the governor’s signature to become law. 

If signed, 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, which counters the effects of a severe allergic reaction. 

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

“Nobody should have to choose between paying the bills and affording their prescription drugs,” said bill sponsor Sen. Dylan Roberts, D-Avon. “Colorado families like the ones I represent on the Western Slope are getting charged an arm and a leg for the EpiPens they rely on to save their lives in emergency situations, and it’s unacceptable.” 

Though EpiPens cost 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.

The program created by the bill would allow uninsured Coloradans to apply for low-cost EpiPens online through the Colorado Division of Insurance’s website. 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 and engaging in a deceptive trade practice if they refuse to participate. 

Senators voted 24-9 to pass the bill on Friday, following the House’s 47-15 approval last month. 

Though HB 1002 received bipartisan support in the House and Senate, only Republicans voted against the bill in both chambers. 

While no lawmakers explained their opposition to the bill during the floor debates, some organizations raised concerns during committee hearings 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.” 

Sponsors said the bill was modeled after the state’s program capping copays for insulin, arguing that since the legislature approved the insulin cap in 2019, there has been no evidence that it resulted in higher insurance premiums. 

During a committee hearing on the bill, Colorado families reported spending up to $4,800 on EpiPens annually, requiring multiple EpiPens to be kept at home, in the car and at their child’s school, among other places. Even when buying cheaper, generic epinephrin injectors, families said they still pay around $170 per pack, plus face constant shortages and early expirations of the injectors. 

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

The bill will next be sent back to the House to approve changes made by the Senate. It will need final approval from Gov. Jared Polis before taking effect on Jan. 1, 2024.