It's the pen you never want to have to use. The EpiPen.
The life-saving device administers epinephrine when someone is experiencing a severe allergic reaction, and now it costs five times as much compared to a decade ago. So parents who are gearing up for the school year now have to tack this pricey item onto their school supply list.
Parents who have high deductibles, have to pay out of pocket for things like EpiPens, which can cost more than $500 just for one box, that contains two devices.
Each year, patients have to update their prescription to buy a new EpiPen. The devices become ineffective after their expiration date.
"I always ask them are you having trouble filling your prescription because with higher deductibles patients are having to pay out of pocket," Allergist Dr. Alma Herrera said.
Dr. Herrera says the biggest problem she sees is people can't afford to stay up to date with their prescription.
Stephani Malloni is a mother of three children. Two have severe peanut allergies. Malloni says she could spend the money she uses on EpiPens in other parts of the family budget.
"She could think of clothes," she said pointing to her daughter, "and he could think of sports stuff, it would go further," Malloni said.
But for a mother, she said, you have to have the device to protect your children. " I'm scared, but it is relieving to have it just in case, even though I don't want to give it to him," Malloni said.
Dr. Herrera said there is virtually no alternative, after the cheaper version, Auvi-Q was recalled for a malfunction.
Experts say it is important for patients to know there is no substitute for epinephrine during a severe reaction.
Parents are left in a financial bind until another alternative comes around.
