The price of EpiPens leads to a settlement between drugmaker and NC
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- NC Attorney General Jeff Jackson announced a settlement with Mylan over price increases.
- The settlement directs millions to the State Health Plan and raises generic coupons.
- Advocates pressed lawmakers for Medicaid funding and bills to reduce waiver waiting lists.
Good morning! Welcome to Under the Dome — a roundup of political news delivered straight to your email. I’m legislative and lobbying reporter Esther Frances with some help from my colleague and politics reporter Luciana Perez Uribe Guinassi.
Wrapping up a busy second week of the 2026 legislative short session, here’s what some state officials and lawmakers have been up to.
NC AG Jackson EpiPen settlement
On Thursday, North Carolina Attorney General Jeff Jackson announced an $11 million settlement over price increases of EpiPen Auto-Injectors. The medication is injected into a person’s thigh if they are experiencing severe allergic reactions.
Jackson, a Democrat, and the N.C. Department of Justice that he oversees alleged that pharmaceutical company Mylan, which markets and distributes EpiPens, used anti-competitive practices to increase the price of the medication.
The NC DOJ alleged that Mylan paid to keep generic epinephrine injectors off of preferred drug lists and made “misleading claims about competing products.”
The settlement also resolved allegations that the company misclassified the medication under the Medicaid Drug Rebate Program, which forced customers to buy two-packs of EpiPens.
Of the full settlement, $4.2 million will go toward the State Health Plan, which covers more than 750,000 people and their families. More than 10,000 of those members filled at least one prescription for an epinephrine auto-injector last year, according to the NC DOJ.
Mylan also agreed to increase its co-pay coupon from $25 to $40 for the generic version of EpiPen, lowering the out-of-pocket cost.
At a press conference on Thursday, Jackson said the office is currently involved in litigation with other drug manufacturers for price fixing.
“This is a very important message to send to prescription drug manufacturers everywhere,” he said, “that if we have good evidence that you’ve broken the law, we’re going to hold you accountable.”
Jackson was joined by North Carolina Treasurer Brad Briner, a Republican, who said the settlement “hits close to home for me” since he and his daughter both carry EpiPens due to severe food allergies.
Briner said that he and the attorney general “obviously sit on different sides of the aisle,” but that they both agree “nobody gets to take advantage of the North Carolina taxpayers.”
“We all understand the challenges that healthcare faces today. It simply doesn’t work for the payers, and it doesn’t work for the patients,” he said. “It only seems to work for the providers, and this is yet one more example of some of the abuses that we see in the system.”
Jackson joined other states in a separate lawsuit against Mylan related to opioid products and settled last year for a total of $335 million. North Carolina received $9 million.
Developmental Disabilities Caucus
For the third year in a row, individuals with intellectual and developmental disabilities and their families, caregivers, and advocates gathered at the North Carolina General Assembly on Wednesday, calling on lawmakers to strengthen Medicaid and the services it funds for this community.
Participants also held listening sessions and a press conference to share personal stories about gaps in care and long wait times. They called for higher pay for direct support professionals, who provide daily assistance. They also want funding for the state’s over 20,000-person waiting list for the Medicaid Innovations Waiver, which covers a wide range of services that allow people with disabilities to live and work in their communities.
Rep. Zack Hawkins, a Durham Democrat and co-chair of the legislature’s Intellectual and Developmental Disabilities Caucus, said he has reintroduced what he called the IDD Omnibus bill, which would raise wages for direct care workers to at least $18 per hour and provide funding to reduce the waiting list. Hawkins said when he joined the legislature in 2019, the waitlist was 17,000.
“As a father of two kids, two rambunctious boys with autism, this work is deeply personal,” he said. But “I don’t just walk in this building for them — I walk in this building to talk about the thousands of stories, including those (shared) today.”
Kay McMillan, 31, spoke at the press conference using an assistive communication device that converted typed text into spoken words. She described how Medicaid-funded home- and community-based services have enabled her to “have a life, not just an existence.”
McMillan, who graduated summa cum laude from NC State University and now runs a nonprofit employing people with disabilities, said she fears losing her independence without Medicaid funding. “You would be sentencing me to a nursing home where I cannot contribute to my community or continue to reach my potential,” she said. She said her 64-year-old mom “cannot be my backup forever, and there are not enough direct support professionals.”
Lawmakers in the GOP-led legislature this week passed a $319 million Medicaid funding bill to address a shortfall. Democratic Gov. Josh Stein signed the measure on Thursday.
Talley Wells, executive director of the North Carolina Council on Developmental Disabilities, said studies show North Carolina remains in the lower tier in meeting needs, while states like Oklahoma have recently been able to meet the needs of everyone on their waiting list.
Rep. Sarah Crawford, a Wake County Democrat who also serves as CEO of a developmental disability services organization, said she was moved by stories shared at the gathering, particularly a mother describing her child finally receiving a waiver slot after a long wait.
“Everyone clapped as if it were an award that had been won. As if it were the golden ticket. And I thought to myself, what a shame— that we are clapping for something that should be a given.”
— Luciana Perez Uribe Guinassi
More headlines from this week
- Months-long Medicaid funding impasse ends as Gov. Josh Stein signs $319M deal
- NC elections director hired private GOP-linked law firm without board approval
- Chapel Hill to Capitol Hill. UNC’s new office raises its profile in Trump-era DC
- Wake cancels in-person classes on Friday as teachers go to Raleigh protest
- What NC GOP Speaker Hall, Senate leader Berger say about teacher march, schools
- North Carolina won’t regulate ‘fairy hair’ after earlier enforcement
- Sen. Thom Tillis wins Federal Reserve battle with DOJ, now backs Warsh nomination
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This story was originally published May 1, 2026 at 5:00 AM with the headline "The price of EpiPens leads to a settlement between drugmaker and NC."
