Mylan and the EpiPen

Hot topics today include the pharmaceutical industry, prescription costs, insurance coverage and life-saving medication.  All of these topics are swirling around in social media and popping up in articles because of the pharmaceutical company, Mylan, and its rising list price of their EpiPen auto injectors.  For me, it’s a double-edge sword.  The high prices suck and it makes me furious that there are folks out there with anaphylactic allergies and no EpiPen.  On the other side, however, I can’t stop thinking about this company who has consistently provided these quality products to the market – these products that I would be dead without.  EpiPens have saved my life more than once.  For that, I have a bucket of gratitude to dump all over their business decision-making heads.  And because of that, I cannot let the blame be unfairly laid only on their shoulders.  I have to make sure people also think about how the insurance companies contribute to this.  How our privatized health care system contributes to this EpiPen financial mess.  And how the government regulations, vendors/suppliers/etc that all contribute to the 2.6-billion-dollar price tag to develop and bring a new drug (life-saving or not) to market.  Having said that, though, Mylan did not develop the EpiPen…


In 2007, Mylan acquired Merck KGaA which included the now hotly debated EpiPen auto injectors (if I remember correctly, this came to the tune of around $6.6 billion big ones…so though Mylan didn’t develop the EpiPen, they paid those big development costs as part of the acquisition purchase).  Since then, the list price of a prescription has increased from under $100 to $600 for a two-pack.  Mylan is a business and business decisions are often focused on creating or increasing profits (especially for publicly traded companies) – from this standpoint, Mylan is a rocking it!  Due to their competitors’ inability to develop a consistent and reliable epinephrine auto injector, Mylan cornered the market and with no competition, had no incentive to keep the price low.  As I mentioned, though, they are a business, not your mama and definitely not Mother Theresa, so what else do we expect?  While expecting more is futile, demanding a business bend to its consumers wants is not new nor unusual…especially when prices skyrocket with no explanation of why.

None of this business-sense means anything to those of use with anaphylactic allergies.  As consumers, we see a product we have to buy if we want to live coupled with fast rising out of pocket costs for that product.  What’s worse is that some of us who are under-insured are stuck paying hundreds of dollars every time we need another EpiPen prescription (or not finding the cash and going without this life-saving medication).  Personally, I am well-insured and my copay is only $30 (which is more than covered by Mylan’s instant rebate program – speaking of which, they did just increase it from $100 to $300 as shown in the graphic below…and increased their patient assistance program for families making up to 4x above the poverty line).  If Mylan wants to keep up these assistance programs, they need to charge a certain amount (unknown to me, but something somewhat substantial) – the reason they need to charge a certain high amount is to, in a way, pass the costs on to the insurance company instead of the patient.  Not ideal, and of course, still driven by business/bottom-line decision making, but an effort to ensure they can pay their 30,000 employees and still get life-saving medication to patients.    

One common theme to today’s hot topics have been an overwhelming shaming of the pharmaceutical industry.  A shaming that is misdirected, misinformed, and to me, hurtful.  I am an employee in this industry.  I grind away on clinical development of new drugs.  I work my butt off with large teams of amazingly brilliant colleagues to try to develop, test, and bring to market drugs for rare diseases for which there are no treatments.  These are diseases that kill people every day.  Every day (yes, I mean 7 days a week), I am filled with the extreme stress of my work, at a detriment to my own health, because as a pharmaceutical industry employee, I want to help improve and save the lives of others – I want to find new medications to give that person losing their fight to Huntington’s disease or losing their quality of life to Lupus a new hope.  Every time I hear someone shame the industry, it eats away at me.  It hurts to have others think I am greedy and filled with bad intentions when I am everything but that.  Please do not expect us to make life-altering and life-saving medications (remember $2.6 billion dollars invested, plus my blood, sweat, and tears) and then give it away for free.  It is an expectation that is not only unfair but absolutely ridiculous.