In an interview with CNN this week, CEO of Imprimis Pharmaceuticals Mark Baum discussed his company’s plans to release an affordable epinephrine auto-injector similar to EpiPen later this year. This comes after a questionable EpiPen cost hike has increased the price of auto-injectors by more than 500 percent since 2008 (1).
Each EpiPen®, produced by Mylan Pharmaceuticals, contains a single-dose injection of a synthetic form of adrenaline, used as an anti-allergy drug in the case of an anaphylactic episode.
Three million Americans carry one around with them—it can be literally a life-saving device.
Sold in a pair, allergy-sufferers purchased almost one million packages in 2013. The product’s only good for one to two years so even if you have one and don’t use it (let’s hope not!), you have to replace it fairly often.
Infuriating EpiPen Cost Hikes
Mylan has come under fire in the last year as consumers have spoken out about its four hundred percent increase in retail price between 2009 and 2016. EpiPens now sell at around $600 for a two-pack. In response, Mylan now offers a generic version at half the price.
Mylan’s CEO tried to blame these hikes on the U.S. healthcare delivery system. All this, while her salary in 2015 was $19,000,000.
“Mylan’s defenders note that the $609 list price of EpiPen may get all of the attention, but most consumers don’t actually pay that. Even before Mylan’s recent cost-cutting moves, the company has indicated that 80% of its prescriptions translate to $0 out-of-pocket expenses,” noted CNN Money’s article on the hike (2).
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This is as Insulting as it is Disgusting
An individual’s out-of-pocket expense may be zero, but SOMEONE is paying: whether it’s Medicare or a private health insurance company.
Where does that money come from? Taxpayers, employers, and anyone paying health insurance premiums.
And what about those who don’t yet have healthcare coverage? They may go without their life-saving medicine simply because they can’t afford it.
Additionally, many people purchasing anti-allergy injectables online from Canada, where the cost is considerably less.
The price hikes are so blatant and heinous that the American Medical Association and Hillary Clinton recently urged Mylan to reduce what it charges for the EpiPen:
“When an allergic reaction leads to anaphylactic shock, a shot of epinephrine can literally be the difference between life and death…But now, just as parents are about to send kids with severe food and insect allergies back to school, the EpiPen’s manufacturer is hiking its price to an all-time high. That’s outrageous—and it’s just the latest troubling example of a company taking advantage of its consumers.” (3)
It’s worth mentioning that children with food allergies have to bring multiple Epipen’s to school. Most school’s require 2-3 pens: one kept at the secretary’s office, one with their homeroom teacher, and one either in the child’s backpack or in their locker.
A Life-Saving Alternative
Mark Baum, head of Imprimis Pharmaceuticals, is famous for offering alternatives to expensive brand-name drugs. Most recently, his company brought to the market a $1 substitute for the $750 AIDS drug Daraprim.
Not surprisingly, he is outraged by yet another price hike caused by the greed of drugmakers.
Baum explains that one milligram of the EpiPen active ingredient (enough to make three) costs a few dollars, “The cost of epinephrine is literally less than a Big Mac”, says Baum. The delivery vehicle for the drug is just as inexpensive.
Imprimis expects that customized versions of its auto-injectable will retail for less than $100. This is possible because it’s a small company and doesn’t have the overhead and production cost of Big Pharma.
Although he is at the head of a for-profit company, Baum is determined to put people above profits. “We don’t have the desire to charge the public even $300 for something that costs so little. That’s not how I want to live my life,” he says (4).
No Trust and Anti-trust
This isn’t the first time the public criticizes Mylan’s marketing practices: the pharmaceutical giant sponsors a program for schools to receive EpiPens free or at a discounted rate. Many states require that public schools stock them.
As part of its program, Mylan imposes the qualification that a school may not buy a similar product from a competitor for twelve months after registration. Not only is this concerning, it’s even illegal.
This has spurred anti-trust attorneys now voice their concerns:
“It is illegal to issue a discount on the condition the customer not acquire a competitor’s goods — if the effect may be to substantially lessen competition,’ said Herbert Hovenkamp, a University of Iowa law professor and antitrust expert.” (5)
Fifteen million people have serious food allergies and that number is steadily increasing. Hundreds of thousands of emergency room visits a year occur as a result of anaphylaxis. While the statistics available of the number of yearly deaths in the U.S. resulting from anaphylaxis are very few, the volume is thought to be relatively very small.
In 2014, researchers at Albert Einstein College of Medicine published a first-of-its-kind study to explore allergic deaths:
“Until now, data on trends in anaphylactic deaths—or even the number of yearly deaths from anaphylactic shock—has not been well-defined. One reason: unlike countries such as the UK, the U.S. doesn’t maintain a national registry for anaphylaxis deaths.” (6)
What they found may surprise you.
“Medications are the leading cause of allergy-related sudden deaths in the U.S... Additional causes identified included unspecified anaphylaxis (19.3 percent), venom (15.2 percent) and food (6.7 percent)… The culprit drugs were not specified in most of the cases (approximately 74 percent). However, among those with an identified culprit drug, nearly half were antibiotics, followed by radiocontrast agents used during diagnostic imaging procedures and chemotherapeutics that are used in treatment of cancer.” (7)
The Epipen cost hike may have attracted attention towards the greed and questionable values of big pharma, but it also brings about bigger questions in regards to why we still rely on such a corrupt industry.