EpiPen Users Have Few Options for Generic or Alternate Drugs

Just one other company is approved to make epinephrine auto injectors.

— -- The rising cost of EpiPens has led many to wonder whether there are cheaper options available on the market.

Recalls from Mylan's competitors have also boosted sales of the EpiPen. Two other companies, AUVI-Q and TwinJect, have recalled their epi injectors over issues with dosage and the device.

There appears to be one other company making an epinephrine auto injector available in the U.S., according to data available from the U.S. Food and Drug Administration. That company, Impax Laboratories, creates an epinephrine injector called Adrenaclick, as well as a generic version of the drug.

“The Adrenaclick is at a lower cost than the EpiPen," Mark Donohue, vice president of investor relations and corporate communications at Impax, told ABC News. “Some pharmacies stock it, and if they do not, they should be able to order it in a day or two."

He did, however, acknowledge that the company does not have the ability to manufacture large quantities of the drug.

"We do not have an automated process but we are working on [one],” Donohue said.

The company is “producing as much as we can to provide it at a lower cost to the patient,” he added.

Impax only acquired the rights to Adrenaclick in March 2015, according to Donohue. Market share of Adrenaclick has since grown from 2 percent to the high single digits.

Dr. Brian Vickery, clinical assistant professor of pediatrics and a pediatric allergist at UNC-Chapel Hill, pointed out another complication for patients: Young children have to be properly trained to use an EpiPen or another epi injector. If a patient or doctor wants to change devices, it means the patient and family members have to re-learn how to use a new device safely.

"There was a time not long ago where there were other drugs on the market ... and they could be substituted and that was an issue because this is a specialized device that requires training and each functions differently," said Vickery.

The device is used "in the context of a rapidly evolving, unpredictable and nerve-wracking situation where a patient or the individual with them is turned into a first responder and they have to make a pretty time sensitive reaction," said Vickery. "The last thing we want is for them to pull out a device they don’t know how to use or misuse it.”

In general, epi injectors have become more commonplace after a 2013 law offered grants to schools if they trained personnel on how to use the devices and kept a supply of epinephrine on hand. While the law pertains to epinephrine auto injectors broadly, on the White House website it's called the "EpiPen Law."

Vickery said he expects more doctors and patients will consider switching to a generic option if possible.

Mylan recently said it has given 700,000 EpiPens to schools for free.

Dr. Kavita Vakharia is a plastic surgery resident at Penn State Hershey Medical Center. She is also a current resident with the ABC News Medical Unit.