Parents refilled Auvi-Q while ExpressScripts still paid for it. Shipped and arrived within two days of requesting refill.
I'm now getting a new scrip to ASPN (Direct Delivery) and seeing how much they sit on it now that my PBM (Caremark) will not cover Auvi-Q. Bet it takes weeks.
In the meantime,
Express Scripts is suing Kaleo (manufacturer of Auvi-Q and Evzio, an autoinjector for opioid overdose).
A lot of the lawsuit is redacted (sensitive info), but Express Scripts is saying that Kaleo had price protection rebates that they paid to Express Scripts (some of which were sent to customers e.g. insurers, and some of which Express Scripts kept for admin overhead). They say from 2014 up until March 2016, Kaleo paid these price protection rebates as they increased the price of Evzio. Then from that point onward, Express Scripts alleges that they invoiced millions to Kaleo for the price protection rebates as agreed, but Kaleo paid them in part rather than in full (breaching the agreement). A lot of the interesting stuff that spells out the exact terms is redacted in full, but basically on February 1st 2016 they quintupled the wholesale acquisition cost of Evzio from a little over $900 to $4500+, and basically immediately stopped paying the price protection rebates thereafter (they paid barely any of the invoiced amount in May 2016, and stopped paying the price protection rebates at all in June 2016).
What the redacted portions block out is the really interesting part - they are likely specific figures and percentages of the rebate scheme. I
suspect the rebates are far in excess of what is normal for a brand name medication (where 50% maybe would be normal), allowing the larger PBMs like Expressscripts to get pricing where they deemed the whole thing worth covering, and allowing Kaleo to negotiate less bargain prices with smaller PBMs or just get wholesale reimbursement of the list from permissive insurance plans.
Considering Kaleo only has two products on market, playing fire with one of the biggest PBMs in the US is pretty gutsy - and judging by ES taking Auvi-Q off the formulary, I expect they are twice burned, once shy. I think the price of Auvi-Q will probably drop substantially in the next year, but time will tell.
EDIT: They got the new scrip from my doctor and called back immediately, they confirmed that they can send me one carton (two injectors/two trainers) in two days, and that they are filling it for me for zero out of pocket since my insurer won't pay. I'll update if it's actually done in a timely fashion as I have heard reports of delays (and when it was re-introduced, my brother's prescription filled when his insurer wouldn't pay took almost three weeks, when they filled it immediately for those of us with insurance who would).
EDIT 2: Shipped from a different pharmacy than the first time a day after filling the scrip with direct delivery. Guess the shortages are over for direct delivery, hear anecdotally that Auvi-Q is still very hard to get at retail.