An EpiPen savings booklet is displayed.

TRAVERSE CITY, Mich. — It has been less than a month since doctors diagnosed 4-year-old Gavin Bourquin with a tree nut allergy.

The preschooler has adjusted well to the change. He keeps a trainer EpiPen in his play doctor’s bag, which he proudly shows off. Those willing to listen will get instructions for using the lifesaving injection device from the four-year-old.

Doctors reccommended that Sarah Bourquin, Gavin’s mother, keep a box of two EpiPens on him at all times. That meant one box at school, one at home and one to travel with. But Bourquin was shocked to learn from a pharmacist that those six EpiPens would cost her more than $2,000.

“I was very surprised,” she told the Traverse City, Michigan Record-Eagle. “I heard the cost had gone up but I had no clue how ridiculous it actually was.”

The EpiPen, a lifesaving epinepherine injection device for people with severe allergies, was available for less than $100 per set when pharmaceutical company Mylan bought the product in 2007. Its cost has risen steadily since, and the device now costs $600 to $700 per set. Mylan CEO Heather Bresch came under a storm of criticism in August, when the company raised the price of an EpiPen two-pack to $608.

Bourquin is among those blaming the EpiPen’s high cost on Mylan — and not insurance deductibles — for raising its prices. The device, she says, feels like an insurance policy in itself.

“You buy one hoping you don’t use it, and you end up throwing away the device you paid all this money for by the end of the year,” she said. “The price of the pen is just stupid in my eyes. I have to pay $2,000 for my son not to die.”

The EpiPen price spike is made worse by the fact that doctors now recommend having two on hand in case another life-saving dose of epinepherine is needed, Howe said. But the cost issue came to a head in the last year, when insurance plans began to change under the Affordable Care Act to include higher deductibles that had to be met before any coverage was provided.

“EpiPen prices have always been high, but people probably had better coverage in their plans,” said Laura Howe, M.D., an adult and pediatric allergist at Bayside Allergy in Traverse City. “It didn’t go from $100 to $700 overnight.”

Prospects for bringing the cost of an EpiPen down quickly seem remote, according to many experts. While Mylan has increased the value of a coupon it offers on EpiPens from $100 to $300, only patients who are commercially insured can take advantage of it. And although the company has also increased the eligibility for its patient assistance program, which allows uninsured patients with an income of up to 400 percent of the federal poverty line to receive free EpiPens, they must still fill out a form, which must be signed by a doctor.

Both steps put an onus on the patient to know about the programs and take steps to access and take advantage of them.

Uninsured patients have dealt with the device’s rising costs in a variety of ways, Howe said. Some have elected to use a less expensive epinepherine injection device, called Adrenaclick, which is still priced at about $400 for a two-pack. Another device, called Auvi-Q, had also been on the market until dosage problems led to its recall last year.

“It was nice when that was on the market, because competition in the drug industry always helps drive prices down,” Howe said.

Ike Swetlitz, a reporter for STAT, a medical journal that covers a variety of issues related to the healthcare field, told the Washington Post that Mylan effectively has cornered the U.S. market on the devices. A generic competitor expected last year has been delayed, but other rivals could be brought to market by late next year, according to the Salt Lake Tribune.

None of that provides any immediate help for the Bourquins, whose insurance coverage doesn’t kick in any until the family meets an annual $2,600 deductible. A box of EpiPens for Gavin would have only cost them $20 under the plan, had the deductible been met, Bourquin said.

“Those with a higher deductible will pay the most,” Howe said. “It’s the people who may have elected for a higher co-pay because they’re generally pretty healthy, but still have this one chronic problem.”

The Traverse City, Michigan Record-Eagle contributed to this story.