The only solution for expanding access to the life-saving EpiPen is to reduce the price
By Sarah Lazare
AlterNet, Aug. 25, 2016
The pharmaceutical giant Mylan has a public uproar on its hands over its 500 percent price increase for a life-saving device known as EpiPen, which delivers emergency shots of the hormone epinephrine to treat potentially deadly anaphylaxis.
In response to the Martin Shkreli-style PR disaster, the company announced Thursday it has devised a supposed solution to the prohibitively high costs of the essential medicine. According to a statement from the corporation, the company plans to “further enhance access to EpiPen” by establishing a discount card and patient assistant system. Here’s how it’s described:
The company is reducing the patient cost of EpiPen® Auto-Injector through the use of a savings card which will cover up to $300 for their EpiPen 2-Pak®. For patients who were previously paying the full amount of the company’s list price for EpiPen®, this effectively reduces their out-of-pocket cost exposure by 50%. Mylan also is doubling the eligibility for its patient assistance program, which will eliminate out-of-pocket costs for uninsured and under-insured patients and families as well.
However, there is a key problem. The reform will not change the base-level cost of EpiPen for consumers. Since Mylan acquired EpiPen from Merck KGaA in 2007, it has hiked the price from $93.88 to $608.61. Under the company’s new plan, the dramatic price increase will not be reversed.
The high price is exacerbated by the fact that EpiPens generally have to be replaced annually, due to expiration.
Robert Weissman, the president of the corporate watchdog organization Public Citizen, was not impressed by the company’s supposed solution. “If the company wants to calm public outrage over its contemptible and unconscionable price spikes for EpiPens, there’s only one course of action: actually lower the price,” he said in a statement released Thursday.
“Coupons, discount cards and patient assistance programs are a false solution for consumers hit with gigantic out-of-pocket costs,” Weissman continued. “First, many consumers will not use the coupons or the programs. Second, many consumers with high deductibles or no insurance will still need to pay far too much for EpiPens—$300 for a set of two—a problem made worse by the facts that many families purchase multiple sets of EpiPens and that EpiPens must be replaced every year.”
Ida Hellander, director of health policy and programs at Physicians for a National Health Program, told AlterNet that she agrees.
“This is not a solution at all,” said Hellander. “Pharmaceutical companies do this for a lot of products. They say that if anyone needs help, we will provide assistance. But they make the guidelines about who can be helped and under what circumstances. And there are so many hoops to jump through that it is a totally inadequate, false solution.”
“The real solution,” said Hellander, “is that they need to drop the price dramatically, but of course they are not going to do that because they are having record profits, and that is their goal. Voluntarily they are not going to do anything. This is another reason we need a single-payer health system where we can negotiate prices with drug companies.”
In Canada, where pharmaceutical prices are subject to regulation by the Patent Medicine Prices Review Board, EpiPen sells for just over $100 per device, distributed by Pfizer Canada via a license from Mylan. According to Weissman, even $100 per pen is “an excessively high price, but at least within the bounds of reasonability.”
EpiPens are commonly used by people with life-threatening allergies, with nearly 4 million prescriptions written last year alone. The spike in prices is forcing people living with allergies, as well as EMTs and other first responders, to resort to more affordable manual syringes—a development that doctors warn presents public health dangers, including an increased risk of the wrong dosage.
Meanwhile, according to Hellander, “you see people hanging on to old EpiPens, not getting new ones when they expire or not having them at all.”
While the price of EpiPen has climbed dramatically, this spike has been outpaced by the salaries of top executives. Heather Bresch, the CEO of Mylan, saw her compensation jump 671 percent from 2007 to 2015.
Sarah Lazare is a staff writer for AlterNet. Follow her on Twitter at @sarahlazare.