As Lisa Savage's son went back to school last week, she still couldn't get her hands on an EpiPen.
Like many parents of children with allergies, Savage likes to have one stocked at school. Her 13-year-old son Jonathan is allergic to peanuts and shellfish.
But the quote from the pharmacy? About $600. And as she called other pharmacies, several told her they were out of the life-saving prescription.
An injection of the drug epinephrine will reverse the effects of an allergic reaction, which can be life-threatening in some people. Jonathan has been to the hospital three times because of his allergies, Savage said.
The back-to-school rush could be exacerbating the shortage, Savage said. Parents of kids with allergies have to consider all of the places where their child could run into an allergen. Savage said she felt for divorced parents, who would need to keep the injectors in both homes, at school and wherever else their child spends time.
Two companies now manufacture the "pens." Mylan was criticized for raising the price of its EpiPens since buying the rights to it in 2007. Under that company's ownership, the price for a pack of two rose from about $100 to $600, The Los Angeles Times reported.
The Food and Drug Administration approved another company, Teva Pharmaceuticals, to market a generic version of the drug in mid-August.
The approval was meant "to advance access to lower cost, safe and effective generic alternatives,” FDA Commissioner Dr. Scott Gottlieb said in a statement.
Still, that version doesn't have a price listing or a release date. In the meantime, Mylan's EpiPen is in short supply. Savage said she tried and failed to get her hands on a generic version.
To help account for that shortage, the FDA extended the expiration date on the EpiPens from 20 to 24 months.
Dottie Farfone, chief clinical pharmacist at the local Dottie's Pharmacy, said people should check the expiration date on the package. In South Carolina, she said, the label pharmacists print defaults to one year. But the medication might last longer.
She also said there are ways to secure financial help for the EpiPens through the manufacturer. A good pharmacist will help a customer find that information, she said.
Farfone said she has never encountered a shortage where she couldn't find a solution for a customer at all.
"You just have to work with someone who knows what they’re doing," she said.
She said EpiPen shortages do happen at the pharmacy once in a while.
Dr. Kenneth Perry, an emergency physician with Trident Health, said people with allergies face a particular time crunch when there is a shortage of epinephrine.
"The tough part with an EpiPen is if someone needs it, they don't have the time to find the pharmacy that has it," he said. "You have to have it."
If a patient comes in to the emergency department with a life-threatening allergy and hasn't had epinephrine yet, someone will draw up the medicine in the hospital, Perry said. But the patient will have to stay in the hospital for longer to be monitored, he said.
He said the price is important for his patients. And if a person's symptoms worsen, they will have to give themselves two injections to buy time to make it to the emergency department.
Many young patients struggle to carry the medications they're supposed to, Perry said.
Savage was able to get Auvi-Q, another injector that delivers the same drug, for $0, a stark contrast to what she would have paid for Mylan's drug. Her allergist contacted the manufacturer.
"I would bet the poorer population don't have 'ties' with private allergists," Savage said in a message. "How do they get the meds?"
Auvi-Q can be free to customers with commercial health insurance, Forbes reported. But it costs their insurers $4,500.