Epinephrine-dispensing EpiPens have become a necessity for families with children suffering from severe allergies. But as the price of EpiPen surges, the potentially life-saving medicine is being skipped by users who have to make a choice between being broke or risking an attack.

In cases of severe allergic reactions, the synthetic adrenaline in EpiPens is used to counter effects like wheezing, uneven breathing, increased or decreased heart rate, swelling and other potentially fatal reactions. While a two-pack of EpiPens cost pharmacies about $100 in 2009, the prices have risen by more than 480 percent to its current price of more than $600, CBS News reported.

“If they don't have [the EpiPen], it could mean life or death,” pharmacist Leon Tarasenko of Pasteur Pharmacy in New York City told CBS. “Within the last two months, we’ve had about three patients who had issues with the price of an EpiPen,” Tarasenko said. “They did not receive it. They just refused to take it.”

While the actual price of the drug is only a few dollars, Mylan — the manufacturer of EpiPen — has few competitors in the field. CBS cited Bloomberg senior medical reporter Robert Langreth who said no significant changes have been made to the device since 2007 other than good marketing.

“This brand name, EpiPen, it’s like Kleenex to allergists,” Langreth said. “You know, it’s a name they know and trust. It’s what they prescribe. ... It’s a totally established brand name with little competition,” Langreth added. “That gives them freedom to raise the price every year.”

Tech Times reported a 67 percent increase in the number of people using Epipens over the past seven years, making the device the main source of revenue for Mylan. The pharmaceutical company told CBS that EpiPen’s price “has changed over time to better reflect important product features and the value the product provides,” as the company “made a significant investment to support the device over the past years.”

Most families with children suffering from severe allergies stock up on EpiPens every year and replace them when they expire. The rise in prices has led to many resorting to syringes filled with epinephrine as a cheaper alternative. This can be potentially lethal if a vein, instead of the muscle, is injected.

Coupons worth up to $100 are offered by Mylan to customers, depending on their medical insurance plans, which allows a number of patients to pay less than the asking price. But many families with insurance plans that have high deductibles receive no such respite and are exposed to high costs.