Cost Is an Adherence Barrier for Epinephrine — Here's How Providers Can Help

As a prescriber, you already know that Neffy (Epinephrine nasal spray) offers a meaningful clinical advantage for patients at risk of anaphylaxis — particularly those with needle phobia, pediatric patients, and caregivers who may hesitate with auto-injectors. But when your patient gets to the pharmacy and sees the price tag, adherence can fall apart.

Neffy's cash price of $685 to $800 for a 2-pack puts it out of reach for many patients paying out of pocket. Even with insurance, prior authorization requirements and high copays can delay or prevent patients from filling their prescriptions.

This guide provides a practical overview of every savings option available for Neffy in 2026, so you can equip your patients — and your staff — with the tools to make this medication affordable.

What Your Patients Are Paying

Understanding the cost landscape helps you anticipate patient concerns:

• Cash price (no insurance): $685–$800 for a 2-pack of Neffy
• With commercial insurance: Varies widely. Some plans cover Neffy with standard specialty copays ($30–$75), while others require prior authorization or place it on a higher tier
• Medicare Part D: Coverage varies by plan. Patients in the coverage gap ("donut hole") may face significant out-of-pocket costs
• Medicaid: Coverage varies by state

For comparison, generic Epinephrine auto-injectors (EpiPen generics) run approximately $150–$350 for a 2-pack, and brand-name EpiPen is $300–$700. Auvi-Q offers a $35 copay program for commercially insured patients.

Manufacturer Savings Programs

ARS Pharmaceuticals offers several programs to reduce patient cost. These should be your first recommendation for eligible patients.

Neffy Co-Pay Savings Program

• Eligibility: Patients with commercial insurance
• Benefit: Patients may pay as little as $0 copay for up to 4 devices (2 packs)
• How to enroll: Visit neffy.com/savings-and-support or call 1-877-MY-NEFFY (877-696-3339)
• Limitations: Not valid for patients using government insurance (Medicare, Medicaid, Tricare, VA)

This program can be activated at the pharmacy with a savings card. Consider having your staff help patients enroll before they leave the office.

Neffy Uninsured Patient Program

• Eligibility: Patients without insurance coverage for Neffy
• Benefit: Patients may pay as little as $25 per prescription
• How to enroll: Same contact — neffy.com/savings-and-support or 1-877-MY-NEFFY

ARS Pharmaceuticals Patient Assistance Program (PAP)

• Eligibility: Uninsured patients with no commercial or government drug coverage
• Benefit: Neffy at no cost
• How to apply: Application through neffy.com/savings-and-support
• Provider role: You may need to submit a letter of medical necessity or prescription as part of the application

For patients who qualify, this is the most impactful program available. Flag uninsured patients proactively and have your team initiate the application during the visit.

Coupon and Discount Cards

For patients who don't qualify for manufacturer programs or need immediate savings at the pharmacy:

GoodRx, SingleCare, and Similar Platforms

Prescription discount platforms may offer reduced pricing on Neffy at participating pharmacies. These are not insurance — they're negotiated discount rates. Patients can:

• Search for Neffy on GoodRx.com, SingleCare.com, or RxSaver.com
• Compare prices at pharmacies near them
• Present the coupon at the pharmacy counter

Note: Discount card prices for brand-name medications like Neffy may still be high. These tools are most useful for patients who are uninsured and don't qualify for the manufacturer's programs, or who need to compare pharmacy pricing.

Pharmacy-Specific Programs

Some pharmacies offer their own savings programs:

• Costco: Often has lower cash prices on brand medications (no membership required for pharmacy)
• Walmart: May offer competitive pricing
• Independent pharmacies: May have more pricing flexibility

Encourage patients to check multiple pharmacies. A tool like Medfinder for Providers can help your practice stay informed about which pharmacies stock Neffy and at what cost.

Generic Alternatives and Therapeutic Substitution

When cost is an insurmountable barrier, consider these alternatives:

Is There a Generic Neffy?

No. There is currently no generic version of Neffy (Epinephrine nasal spray). Neffy is the only FDA-approved intranasal Epinephrine product.

Therapeutic Alternatives

If a patient cannot afford Neffy, the following Epinephrine products deliver the same active ingredient via intramuscular injection:

• Generic Epinephrine Auto-Injectors (Teva, Viatris) — $150–$350 for a 2-pack. The most cost-effective option for patients who can use an injectable device.
• Auvi-Q — Compact auto-injector with voice guidance. $35 copay program for commercially insured patients. Available in 0.1 mg, 0.15 mg, and 0.3 mg doses.
• EpiPen — $300–$700 for a 2-pack. Generic versions available at lower cost.
• Adrenaclick / Generic — Lower-cost injectable option. Available in 0.15 mg and 0.3 mg.
• Symjepi — Pre-filled syringe. Available in 0.15 mg and 0.3 mg. Compact form factor.

The clinical decision should weigh the patient's ability to use an injectable device reliably. For patients with documented needle phobia, physical limitations, or caregivers who are uncomfortable with injections, Neffy's needle-free delivery may justify the higher cost due to improved likelihood of actual use during an emergency.

For a detailed comparison, see our clinical guide on alternatives to Neffy.

Insurance and Prior Authorization Strategies

When a patient's insurance doesn't cover Neffy or requires prior authorization:

Prior Authorization Tips

• Document needle phobia or injection difficulty — This is the strongest clinical justification for Neffy over traditional auto-injectors
• Note any history of auto-injector non-use — If the patient has previously failed to use an auto-injector during an emergency due to fear or inability
• Cite the patient population — Pediatric patients, elderly patients, and patients with physical disabilities may benefit from needle-free delivery
• Include the FDA approval data — Neffy is FDA-approved and clinically proven

Appeals

If initial PA is denied, appeal with:

• Letter of medical necessity detailing why Neffy is clinically preferred over alternatives
• Documentation of failed auto-injector use or patient-specific barriers
• Supporting literature on needle phobia and epinephrine non-adherence

Building Cost Conversations Into Your Workflow

The most effective way to help patients save money is to address cost proactively — before they get the pharmacy surprise.

At the Point of Prescribing

• Ask: "Do you have concerns about the cost of this medication?"
• Mention the manufacturer savings program and have your staff provide the enrollment information
• For uninsured patients, initiate the Patient Assistance Program application during the visit

Train Your Staff

• Front desk and MA staff should know about the Neffy savings programs
• Keep printed or digital information about neffy.com/savings-and-support readily available
• Designate a team member to help with prior authorizations and PAP applications

Follow Up

• Check at follow-up visits whether the patient successfully filled their Neffy prescription
• If they didn't fill it, identify the barrier (cost, availability, insurance) and help resolve it
• Use Medfinder for Providers to help patients locate pharmacies with Neffy in stock

Provide Resources

Direct patients to these resources:

• Neffy savings: neffy.com/savings-and-support or 1-877-MY-NEFFY
• Finding Neffy in stock: Medfinder
• Patient education: Share our guides on saving money on Neffy and finding Neffy in stock

Final Thoughts

Neffy's needle-free delivery is a genuine clinical advancement for anaphylaxis-prone patients, but its value is only realized if patients can afford to fill and carry it. By proactively connecting patients with manufacturer savings programs, assisting with prior authorizations, and building cost conversations into your workflow, you can significantly improve adherence and ensure your patients are protected.

The key programs to remember:

• $0 copay for commercially insured patients (Co-Pay Savings Program)
• $25 per Rx for uninsured patients
• Free Neffy through the Patient Assistance Program for eligible uninsured patients

For practice-level tools and resources, visit Medfinder for Providers.