Cost of EpiPens Skyrockets

[zzz]

This is becoming all too much routine. People's lives are being sacrificed in the name of the "free market". But Big Pharma has one of the biggest and most highly funded lobbying organizations around. What to do?

From The New Republic:

Clio Chang
2 hours ago

AP Images
Meet the Martin Shkreli of allergies.

According to NBC, Heather Bresch, the CEO of Mylan, a pharmaceutical company that bought the rights to EpiPens in 2007, has raised the price of the pens, which are used in emergencies to treat severe allergic attacks, by 400 percent over the last eight years. (Bresch’s pay, in the meantime, has increased by 671 percent.) That means that EpiPens, which used to cost around $94, now sell for an average of $608. Bad news for kids with life-threatening allergies! Members of Congress are demanding more explanation from Mylan on the price increases.

Perhaps even more insidious is the fact that Mylan spent millions on lobbying over the past decade. In decisions that directly benefited Mylan, the FDA in 2010 recommended that EpiPens be prescribed not only to patients with confirmed allergies, but also those who are at risk. The agency also recommended packaging two pens together as opposed to selling single doses.

Martin Shkreli, who is one of the most hated men in America, weighed in on the matter this morning, stating that the price was actually “quite a bargain,” especially if you consider the much higher costs of going to a hospital for anaphylactic shock.

In other words, suck it up you allergen-whining, free market–hating goons!

The referenced article on NBC is quite enlightening; it's followed by a second article detailing other abhorrent practices by Mylan.

Generally, people who cause this much harm to others are supposed to go to jail. These people just get paid more.

 

[geraldt52]

Because of a bee sting allergy, I have carried adrenaline for 40 years. Before EpiPens, you simply got a "bee sting kit", which consisted of a small vial of adrenaline, a syringe, and some alcohol wipes, in a small plastic case that easily fit in your shirt pocket. Ten minutes with an orange, and you could teach a ten year old to use it...I actually found it easier than the Epipen. Cost of a kit was like $10, as late as 20 years ago. A couple of years after the Epipen was introduced, you could no longer buy the "kits". The Epipens have been nothing more than a money grab from the day they were "invented", and it only gets worse.

 

[frog_in_the_fog]

I have been following this since it was recommended I get one of these epipens. Who knows if anything will come of the bad press, since this company really doesn't want to budge on the price. This is a case where progress stomps on everyone to get every last dime, nickel, and penny. What a terrible shame...

 

[*GG*]

This is becoming all too much routine. People's lives are being sacrificed in the name of the "free market". But Big Pharma has one of the biggest and most highly funded lobbying organizations around. What to do?

The Market is anything but free, wake up!

GG

 

[Gingergrrl]

@zzz Thanks for posting this and I just read both articles which are sickening and horrifying. I have an EpiPen (actually one at home and one in my purse at all times) for MCAS even though thus far, I have never had to use it b/c I am on an excellent med regime which makes it unnecessary. But I would never be without one in a true emergency should this ever occur.

But for the people who do have use it weekly (and some on my Mast Cell boards use them multiple times a week!), I cannot imagine how they would pay for it? These Pharma CEO's just have no mercy or concept of what it is like to have to pay for a life-saving medication, especially if it is for your child.

 

[Gingergrrl]

http://www.cnn.com/2016/08/24/politics/epipens-congress-response/index.html

Additional article from CNN on this same topic re: two members of congress- one whose daughter has life threatening allergies and relies on EpiPen and the other whose daughter is the head of Mylan !

 

[Groggy Doggy]

My medication, Forteo, also has a history of huge price hikes. For a 28 day supply (product expires 28 days after you open it):

Q4 2009 $362 (per Bloomberg)
Q4 2015 $967 (per Bloomberg)
08/24/16 $2,829 (per Costco)

So in the last 9 months, my medication has increased almost 300%
Since 2009, its increased 780%

This is outrageous!

http://www.bloomberg.com/graphics/2016-drug-prices/

 

[Gingergrrl]

Question to @zzz or anyone in the thread who knows the answer... I read in one of the articles (now I don't remember which one) that the U.S. government has given Mylan a monopoly so no other company is allowed to make an EpiPen (or a comparable product with another name). How is this legal? I thought once a medication goes off patent that all other companies were allowed to make a generic version?

Plus Epinephrine itself already exists so they are not actually creating something new so why wouldn't other companies be allowed to use an existing product? As an example, I get it that only Tylenol (the brand) can use that name but hundreds of companies can sell Acetaminophen under the generic name. So how is an EpiPen different and since when can the US government give one company a monopoly on a medication after it goes off patent?

I read that in Canada, EpiPen is only $100 (versus $600) and that you don't even need a prescription and can just choose to buy one at pharmacy (not sure if this is true?) but that is incredible if it really is!

 

[Forbin]

Last year, King County, Washington - which encompasses Seattle - dropped EpiPens for their emergency services in favor of kits containing syringes (probably similar to the "bee sting" kits you once could get). I think the county contracts their manufacture - so I don't think they are available to the general public. According to the article below, the kits cost the county just $10 each. The argument against them is that they take a minute or so longer to administer. For some reason, it sounds like they're using a vial and syringe - which would slow you down a bit. The old "bee sting" kits I remember just came with a pre-loaded syringe.

http://www.seattletimes.com/seattle-news/king-county-drops-epipen-for-cheaper-kit-with-same-drug/

I was instructed to get one of those "bee sting" kits back in the 1980's when I was self-administering allergy shots on a nearly daily basis as a trial treatment for my balance impairment (without much result).

I found that old "bee sting" kit in the back of a medicine cabinet about 25 years later. The epinephrine fluid had turned the color and consistency of maple syrup - so, yes they do expire.

 

[Valentijn]

How is this legal? I thought once a medication goes off patent that all other companies were allowed to make a generic version?

The patent is for the design of the injection pen, not for the epinephrine itself. And I don't think the status of the relevant patent(s) is particularly clear. They have claimed the patent expires in 2025 in court, but it sounds like that was settled by the company "allowing" a generic competitor into the market.

The patent is probably somewhat broad, and trying to cover nearly any one-step injection method. So if anyone wants to compete, they're going to have to go to court to fight with Big Pharma. That's going to discourage any smaller competitors, and other large pharamceutical corporations might prefer to play nice with eachother, especially when real competition would make the product very cheap and not a big money-maker.

The FDA rejected the generic alternative, maybe due to the injection device not being tested enough, even if it's substantially similar to the EpiPen. Again, that can be a significant cost-burden.

 

[frog_in_the_fog]

It seems all the bad press had some positive effect.
http://www.cnbc.com/2016/08/25/myla...-programs-after-charges-of-price-gouging.html

 

[Valentijn]

It seems all the bad press had some positive effect.

Lip service, mostly. And a "savings card" sounds like what is usually used to encourage people to buy/spend more.

They're making gestures to avoid real regulations, which seems to be quite necessary at this point.

 

[Groggy Doggy]

Why Mylan’s ‘savings card’ won’t make EpiPen cheaper for all patients

https://www.washingtonpost.com/news...an-will-expand-patient-assistance-for-epipen/

 

[frog_in_the_fog]

I would not qualify for any discount in my situation, but at least some will be able to afford it.

 

[Gingergrrl]

The patent is for the design of the injection pen, not for the epinephrine itself.

Thank you and I did not get that part!

The patent is probably somewhat broad, and trying to cover nearly any one-step injection method. So if anyone wants to compete, they're going to have to go to court to fight with Big Pharma. That's going to discourage any smaller competitors, and other large pharamceutical corporations might prefer to play nice with each other, especially when real competition would make the product very cheap and not a big money-maker.

That makes perfect sense but is a truly messed up system. It is starting to feel like Monsanto and what they did to the farmers who refused to use their product until they were forced to do so.

The FDA rejected the generic alternative, maybe due to the injection device not being tested enough, even if it's substantially similar to the EpiPen. Again, that can be a significant cost-burden.

If the alternative is defective or not as good quality, then I support the FDA requiring further testing. But it sounds like a corrupt conspiracy at the moment.

I was also curious, is the delivery system of the EpiPen the only injection pen in existence for any medication or are there other meds that are delivered this way? I never thought about it before but it seems like there must be something else delivered by this method even if only in an emergency room? Or is the method truly that unique to the history of medications that they hold the monopoly? Hope I am asking my question where it makes sense!

 

[Valentijn]

I was also curious, is the delivery system of the EpiPen the only injection pen in existence for any medication or are there other meds that are delivered this way?

There are probably very similar systems for other meds. But they would have different dosages, and maybe other differences in the injecting process (needle length, width, etc). So they can't just grab a generic injecting device, and swap out the insulin or whatever with epinephrine.

But this is where the FDA might be getting too picky. If the injector is safe, and it's the right dose of epinephrine, then it should reasonably work just fine. But they're probably requiring companies to show that their specific injector works fine with epinephrine for anaphylaxis.

This is where I think it would be good to have some sort of funding for helping companies develop or trial products, if there's a big public interest and the companies being helped agree to certain pricing restrictions. And the FDA could probably a bit more reasonable - if a syringe + a vial of epinephrine is fine, then so is a basic injector shown to generally work in the past, even if it now has epinephrine in it.

 

[actup]

I panicked when the EpiPen story hit the news as I am very sensitized to yellow jackets after having been swarmed fairly recently. Got eight stings with nasty reactions and a bad crash. Would have been worse but my son brushed many of the wasps off of me. Fortunately I just found out that the brand name EpiPens are available from online pharmacies with cost comparisons at pharmacychecker.com. They cost as little as $106 US ( to think that only a couple of years ago I thought this was an outrageous price).

http://www.pharmacychecker.com/brand/price-comparison/epipen/0.3+mg/

This company was started by Dr Ted Cooperman who owns consumerlabs.com. More info on the company:

http://www.thehonestapothecary.com/2013/06/13/buying-prescriptions-online-pharmacychecker-com/

 

[Gingergrrl]

Not sure if this was already posted but I just read that Sarah Jessica Parker, who was a spokesperson for EpiPen b/c her son has a peanut allergy, has withdrawn her support and stepped down due to the recent price hikes.

I read her statement and agree with everything she said re: all the parents who can no longer afford to buy EpiPens for their children and she cannot endorse a company like Mylan anymore (am paraphrasing and not her exact words).