People in the US continue to battle with high drug prices and the recent controversy around Epipen (Epinephrine injections) is another example that has drawn attention to the escalating drug prices. Anaphylaxis is a serious life-threatening allergic reaction, which in the United States has increasingly become a reality for millions of people suffering from allergies and asthma. Epinephrine injections serve as the first line of treatment for such a medical emergency, in case a reaction occurs, which can be very quick as well as fatal.
While the drug epinephrine is available since many decades in generic form, the auto injector used to deliver the drug is patented enabling companies like Mylan to charge really high and prohibitive prices.
Epipen has been in use since 1977. In 2007, when Epipen was bought by pharma company Mylan the list price of a two-pack of the drug was $93.88. Although an FDA approved generic epinephrine auto-injector has been on the market since 2003, due to Mylan’s extensive marketing strategy, Epipen has become synonymous with an epinephrine auto-injector, so much so that even when doctors prescribe the product, Epipen comes to mind. EpiPen is protected by patents on the device, particularly the safety cap on the needle. It is noteworthy that 1 milliliter of epinephrine costs less than a dollar in the developing world, and that less than a third of a that goes into an EpiPen.
Mylan jacked up the price of Epipen almost over 400 times over the span of last few years.
The reasoning behind this high price by Mylan was that it “reflect the multiple, important product features and the value the product provides,” but declined to provide specifics about those features.
This led to a havoc among the people resulting in a petition to Congress raising concerns about the price increase, called “Stop the EpiPen Price Gouging,” on social media. This petition reached more than 80,000 people who sent nearly 144,000 messages to Congress. Many Congressmen including Hillary Clinton and Bernie Sanders, called on Mylan to lower EpiPen prices.
Mylan CEO, giving into public pressure, announced that the company would expand its coupon and patient assistance programs to help patients who were facing higher out-of-pocket costs. Recently, the company agreed to a $465 million settlement with the U.S. Department of Justice for overcharging on the product.
In efforts to curb public outrage over its price increases, Mylan recently introduced a generic version of its own product. According to Mylan, the generic EpiPen is identical to the existing product, but has a wholesale list price of $300 for a pack of two, half the price of the brand-name EpiPen. It is notable that even this generic is still a lot more expensive than what EpiPens used to cost.
Mylan controls nearly 90 percent of the market for epinephrine injectors due to its aggressive marketing and lack of competition and so can again raise the price anytime in the future. The question thus remains- will the US government take steps to provide a congenial environment to promote healthy generic competition to break the monopoly of such pharmaceutical companies? Will it pave the way to make drugs and diagnostics affordable and available to those who need them most?
________________________________________________________________Written by Pragya Singh, Master’s Candidate Human Rights and Humanitarian Action at Sciences Po, France.