Dr. Allen Lieberman, an allergist who specializes in food allergies with The Allergy and Asthma Center of Austin, helped push for stage passage of 2015 state legislation to allow schools to stock EpiPens, a drug that reverses allergic reactions.[/caption] Recent price hikes for epinephrine auto-injector EpiPen have Austin allergists worried about how their patients can afford the drug, which is used against life-threatening allergic reactions. Dr. Allen Lieberman with the Allergy & Asthma Center of Austin said the price increase to $600 for a two-pack of the device has been a "huge problem" for his patients, with some choosing to go without the EpiPen. "The EpiPen is like your airbag," he said. "You want it there in case you need it, but you really hope it doesn’t go off." When a patient has an allergic reaction and doesn't have an EpiPen handy, Lieberman said it can lead to anaphylaxis, which is life-threatening and has to be reversed by a dose of epinephrine. He suggested patients susceptible to allergic reactions have two EpiPens everywhere they go—at school, at home, in the car and at daycare, for example, but that can get expensive. "It’s shameful that people have to make that decision about whether their children can afford their medicine," he said. EpiPen manufacturer Mylan currently offers schools free EpiPens thanks to a law passed in 2015 that allows and encourages schools to be prepared with extra EpiPens if a student forgets his or her device. The EpiPen4Schools program gives schools four free EpiPens, a replenishment product, a storage unit in which EpiPens are kept and a guide for using the device. Lieberman, who pushed for the law to be passed, said he is concerned about what would happen should Mylan stop providing the EpiPens for free. Studies have shown, he said, that since the law has passed both children and adult lives have been saved thanks to the extra devices in schools. So far, Lieberman said Mylan has given no indication it would stop providing the free EpiPens to schools. While epinephrine itself is relatively inexpensive, Dr. Alexander Alvarez, an allergist at Allergy and Asthma Consultants in Austin, said his patients have had difficulty paying $600 for a two-pack of EpiPen. “We’ve known about this cost increase for a long time, and it certainly has impacted a lot of our patients negatively,” he said. Alvarez said he has occasionally given EpiPen samples provided by Mylan, but those are rare. “I’ll usually do anything I can to get [patients] an EpiPen,” he said. He has also looked into prescribing Adrenaclick, another epinephrine auto-injector made by Amedra Pharmaceuticals, but he said not many people know about the alternative to EpiPen, and pharmacies typically don’t stock the product so it has to be specially ordered. He said his patients have purchased Adrenaclick for around $140. Mylan announced Thursday plans to expand its savings program, which covers up to $300 for the drug. The company said it is also doubling the eligibility for its patient assistance program, which will eliminate out-of-pocket costs for uninsured and under-insured patients and their families. Under the patient assistance program, Mylan said a qualifying family of four making up to $97,200 would pay nothing out-of-pocket for the EpiPen. The savings program announcement comes after the company faced scrutiny from legislators and Democratic presidential candidate Hillary Clinton, who said in a statement Wednesday the price increase was “outrageous” and “troubling.”