DrugDashboards

Adrenalin

epinephrine · EPINEPHRINE 1 mg/mL · Injection · Intramuscular; Intravenous; Subcutaneous · Par Health USA, LLC

NDC 42023-0159-25 · 25 VIAL in 1 CARTON / 1 mL in 1 VIAL · NDA · View full market →

The short version

25 companies supply this market — deep enough that no single failure threatens the supply. The price has fallen 45% in a year, to $7.80 per mL — and generics that get this cheap tend to get abandoned rather than defended. One of its named manufacturing plants, Par Health USA, LLC, failed FDA inspectionwithin the last two years — the agency’s most serious outcome. Put together: worth watching — several of the pressures that precede supply trouble are present at once. Historically, drugs in this position went on to a new shortage within 90 days about 0.5% of the time — roughly 4× the typical drug (0.1%).

The numbers behind every sentence are on this page below — and the Watch button emails you when any of them move.

One drug, every price

The same NDC has different prices depending on who is paying. Units differ between rungs — compare within a rung over time, not rung against rung, unless the units match.

ⓘ How this was built
Data sources
  • CMS NADAC (pharmacy acquisition, weekly)
  • CMS Part B ASP quarterly payment limits
  • CMS Maximum Fair Prices (IRA negotiated, NDC-level)
  • Medicare Part D Spending by Drug (data.cms.gov, name-matched)
  • VA FSS / Big4 federal contract prices (va.gov, twice monthly)
  • ACA Federal Upper Limits + weighted AMP (data.medicaid.gov, monthly)
  • California SB-17 WAC filings (list price, per package)
Method

Each rung is the newest figure for this NDC from one federal price system, shown with its own unit. Part D is matched by drug name because CMS publishes no NDCs there; it is gross spending, before confidential rebates.

Pipeline and calculations built by Claude (Fable 5) from the public datasets above. Educational only — verify against primary sources before acting.

  • Pharmacies pay (NADAC)$7.80per MLinvoice-surveyed acquisition cost · Oct 28, 2025
  • Medicare Part B pays (ASP+6%)$0.7830per billing unit (0.1 MG)HCPCS J0169 · Jul 1, 2026
  • Part D plans paid (avg)$13.74per dosage unitgross, before rebates — matched by drug name · 2024
  • Federal ceiling (Big4)$62.62per package of 25X1MLEndo USA, Inc. · Jan 1, 2025

Medicare Part D

No Medicare Part D plan in CMS's quarterly files lists this product. That usually means it is discontinued, a repackager's listing, or a product no plan has added to its formulary.

How Part D pricing works →

NADAC price per unit

$0$5.00$10.00$15.00Apr 2024Oct 2025$7.80
21 price points · per ML · last surveyed Invalid DateSource: CMS NADAC

Estimated fill cost

WAC per package, as filed
$205.00
Reported to Texas DSHS · 2026 annual filing · Par Health USA, LLC

Manufacturer list price as filed — not what pharmacies actually pay after discounts.

Medicare Part B (ASP)

Payment limit per 0.1 MG
$0.783
HCPCS J0169 · Jul 1, 2026 quarter · typically ASP + 6%

Medicaid spend (2025)

$191,051
11,903 prescriptions paid by Medicaid nationally · all Medicaid spend →

Supply fragility

33Elevated risk

The score is counting real pressure here. One of these alone is routine; it’s the combination that makes this market worth watching.

  • Class I/II recall on same molecule/form in past 12 months+8
  • price down 45% year over year+15
  • sterile injectable+10

The score counts pressure that is already visible — fewer makers, shortages, recalls, falling prices. 0 means none of it; 100 means all of it at once. Recomputed daily · as of Sep 3, 2026

90-day shortage risk (model v2)

0.5%chance of a new FDA shortage posting for epinephrine (injectable) in the next 90 days

sterile injectable · OAI inspection at a producing facility (24 months) · sole-source market

For scale: the typical drug’s chance is about 0.1% — this one is 4× that.

Backtested statistical model over the whole market, not this package alone. Model details →

Where it's made

Establishments this product's FDA label declares, located via FDA registration data. How we built this →

Is this a "specialty" drug?

There's no legal definition — it meets 1 of 6 public criteria. Why that matters →

  • Part D specialty tier
  • Costs ≥ $950/fill · avg $20.71 per prescription
  • Biologic (BLA)
  • Injectable / infused
  • Orphan-drug exclusivity
  • REMS program

Regulatory

Application
NDA204200
TE code
AP
Approval date
Dec 7, 2012
Patents / exclusivity
3 patents, 0 exclusivities
TypeNumber / codeExpires
patent9295657Mar 13, 2035
patent9119876Mar 13, 2035
patent12280024Mar 13, 2035

Shortage history

No FDA shortage reports for this drug or its presentations.

Recalls (this NDC)

  • Class II · CompletedJan 17, 2024
    Henry Schein Inc. and Glove Club HSI Gloves Inc.Labeling: Incorrect or Missing Lot and/or Exp Date. The expiration date listed on the Repack Pouch Label is incorrect.
  • Class III · OngoingMar 16, 2023
    Focus Health Group IncLabeling; Incorrect NDC number on outer carton of product.
  • Class II · TerminatedApr 13, 2022
    Mckesson Medical-Surgical Inc. Corporate OfficecGMP deviations: Temperature abuse

Manufacturers of epinephrine (Injection)

LabelerStrengthFirst seenLast seen
Asclemed USA, Inc.EPINEPHRINE .3 mg/.3mLJul 15, 2026Sep 3, 2026
HF Acquisition Co LLC, DBA HealthFirstEPINEPHRINE 1 mg/mLJul 23, 2026Sep 3, 2026
HF Acquisition Co LLC, DBA HealthFirstEPINEPHRINE .3 mg/.3mLJul 15, 2026Sep 3, 2026
Par Health USA, LLCEPINEPHRINE 1 mg/mLJul 15, 2026Sep 3, 2026
Remedyrepack Inc.EPINEPHRINE .3 mg/.3mLJul 15, 2026Sep 3, 2026
A-S Medication SolutionsEPINEPHRINE .1 mg/mLJul 15, 2026Sep 2, 2026
A-S Medication SolutionsEPINEPHRINE .15 mg/.3mLJul 15, 2026Sep 2, 2026
Advanced Rx Pharmacy of Tennessee, LLCEPINEPHRINE .3 mg/.3mLJul 15, 2026Sep 2, 2026
American Regent, Inc.EPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
Amneal Pharmaceuticals LLCEPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
Amneal Pharmaceuticals of New York LLCEPINEPHRINE .15 mg/.15mLJul 15, 2026Sep 2, 2026
Amneal Pharmaceuticals of New York LLCEPINEPHRINE .3 mg/.3mLJul 15, 2026Sep 2, 2026
Amneal Pharmaceuticals Private LimitedEPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
Asclemed Usa Inc.EPINEPHRINE .3 mg/.3mLJul 15, 2026Sep 2, 2026
Asclemed USA, Inc.EPINEPHRINE .15 mg/.15mLJul 15, 2026Sep 2, 2026
BPI Labs, LLCEPINEPHRINE 30 mg/30mLJul 15, 2026Sep 2, 2026
Bryant Ranch PrepackEPINEPHRINE .15 mg/.3mLJul 15, 2026Sep 2, 2026
Catalent Indiana, LLCEPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
Catalent Indiana, LLCEPINEPHRINE .5 mg/mLJul 15, 2026Sep 2, 2026
Gland Pharma LimitedEPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
Henry Schein, Inc.EPINEPHRINE .1 mg/mLJul 15, 2026Sep 2, 2026
HF Acquisition Co LLC, DBA HealthFirstEPINEPHRINE .15 mg/.15mLJul 15, 2026Sep 2, 2026
HF Acquisition Co LLC, DBA HealthFirstEPINEPHRINE .1 mg/mLJul 15, 2026Sep 2, 2026
HF Acquisition Co LLC, DBA HealthFirstEPINEPHRINE .15 mg/.3mLJul 15, 2026Sep 2, 2026
Hikma Pharmaceuticals USA Inc.EPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
International Medication Systems, LimitedEPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
International Medication Systems, LimitedEPINEPHRINE .1 mg/mLJul 15, 2026Sep 2, 2026
Medical Purchasing Solutions, LLCEPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
Medical Purchasing Solutions, LLCEPINEPHRINE .15 mg/.3mLJul 15, 2026Sep 2, 2026
Medical Purchasing Solutions, LLCEPINEPHRINE .1 mg/mLJul 15, 2026Sep 2, 2026
Medical Purchasing Solutions, LLCEPINEPHRINE .3 mg/.3mLJul 15, 2026Sep 2, 2026
Medical Purchasing Solutions, LLC.EPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
Novo Nordisk Production Belgium SAEPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
ProPharma DistributionEPINEPHRINE .1 mg/mLJul 15, 2026Sep 2, 2026
ProPharma DistributionEPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
Redpharm DrugEPINEPHRINE .3 mg/.3mLJul 15, 2026Sep 2, 2026
Remedyrepack Inc.EPINEPHRINE .1 mg/mLJul 15, 2026Sep 2, 2026
Remedyrepack Inc.EPINEPHRINE .15 mg/.15mLJul 15, 2026Sep 2, 2026
Sina Health IncEPINEPHRINE 1 mg/mLJul 15, 2026Sep 2, 2026
Teva Pharmaceuticals USA, Inc.EPINEPHRINE .5 mg/mLJul 15, 2026Sep 2, 2026

Roster from daily NDC Directory diffs — first/last seen dates start July 2026.

Cite this page

DrugDashboards, "Adrenalin — NDC 42023-0159-25," retrieved September 3, 2026, https://drugdashboards.com/drug/42023015925.

Free to cite with attribution — see how the data is put together.