By Dr. Mallika Marshall

BOSTON (CBS) – Diagnosed with a severe peanut allergy, one wrong bite could be deadly for 10-year-old Dylan Frazier of Duxbury. That’s why his mom, Kristen, keeps EpiPens everywhere. “We keep one in the cafeteria. We also keep one in the classroom and in the sports bag,” she said.

The Fraziers’ insurance doesn’t cover the cost of all those extras, so they end up with hundreds of dollars in out-of-pocket costs just have that peace of mind.

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What Kristen and many of her friends who have kids with similar allergies didn’t know is there is a cheaper alternative. It is the generic epinephrine auto injector. It has been on the market since 2013 and the cash price is as much as $430 cheaper than the EpiPen.

“I’m surprised that I didn’t hear about this because I think I’m pretty astute as to what is going on,” she said when we told her about the drug.

The device is actually the generic for another brand of epinephrine injector called the Adrenaclick. “It’s the same medication,” explained Dr. Arthi Thangarj of Beth Israel Deaconess Hospital in Plymouth. So why aren’t doctors prescribing it? She believes it’s a lack of awareness among patients and some physicians.

Emergency Room Doctor Ron Berrol agrees. “It’s like Kleenex. We don’t say ‘facial tissue,’” he explained. “When I think of epinephrine auto injector, the first word that comes to mind is EpiPen.”

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According to Dr. Berrol, the manufacturer of EpiPen, Mylan, also does an excellent job promoting its product. He also believes there is some confusion over how to write a prescription for the cheaper generic. “There are many providers who think, ‘I’ll write a prescription for the EpiPen or the generic equivalent’ not realizing pharmacists can’t substitute it,” he said.

Dr. Thangaraj explained that even though the medication is the same, the devices are not identical, so if the prescription is written for the EpiPen that’s what will be dispensed. “Your prescription should say ‘the generic epinephrine auto injector’ for you to get the cheaper drug,” she said.

The main difference lies in the device itself. There are two caps that need to be removed before the drug can be administered in the generic version, the EpiPen has just one.

According to Kristen, Dylan’s doctor thought it was important the boy stick with the device he knows. But as he gets older, she likes the idea of the cheaper alternative. “I think if it works just as effectively and if we can be confident that he can use it as well as the other option, then I would be on board,” she said.

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The EpiPen manufacturer is expected to release its generic for about $300. That’s still about $100 dollars more than the auto-injector.

Dr. Mallika Marshall