The Death of Affordable Prescriptions

Bao Huynh, Assistant Editor

It’s a standard lunch day for you and your friends. The table’s already been reserved, you’re already deep into the mundane conversation of the day. All of a sudden, you realize something isn’t right. Your lips are beginning to puff up, and your throat is starting to itch. Next thing you know, your throat is closed up and you can’t breathe. Now, imagine not being able to pay for the very drug that would save your life.

This is increasingly becoming a real-life scenario.

Mylan, a major pharmaceutical company, has been dealing in recent months with the fallout of its decision to raise the price of EpiPens to $600 for a two-pack. Despite a great amount of criticism, Mylan’s CEO, Heather Bresch, has not backpedaled and is keeping the hefty price tag.

Anyone with severe allergies relies on epinephrine to counteract what could be a fatal reaction, and the price hike of EpiPens presents a developing and intensifying problem within the world of medicine: profit margins are valued more than the well-being of people.

Ever since Mylan’s acquisition of the EpiPen brand, its price has been slowly rising since 2007. After first increasing the price of EpiPens by about 30 percent, Mylan saw impressive profits of around $1 billion. Now up by over 400 percent, the new price means profit for the company has never been higher. Bresch’s own salary has skyrocketed by more than 600 percent, from $2 million to nearly $19 million.

When interviewed about the price raise, Bresch shifted blame to the healthcare system as a whole, insisting that the higher prices are to ensure Mylan profits after paying the middlemen who handle the product. However, these middlemen take a small percentage compared to Mylan, who walk away with nearly $300 in their pockets for every single EpiPen sold—all without breaking a single law.

It’s estimated that the epinephrine injectors sold only cost the company around $30 per unit to manufacture, a price that would be much easier to swallow for those who depend on it. However, low prices simply aren’t an option for them, even with insurance copayment. The typical copayment offered still only brings the price of a two-pack down to $300.

In some ways, different companies have allowed this price gouging to happen. Mylan holds a monopoly on the market of epinephrine injectors, due to a lack of viable alternatives. Being the owner of the EpiPen brand, they are allowed to raise the prices as much as they want, a situation not unlike the controversy surrounding Martin Shkreli last year, who marked a specialized drug up by over 5000 percent.

What makes this more of a problem than Shkreli’s case would be the fact that epinephrine isn’t a specialized drug; rather, it’s an incredibly common drug used for allergies practically worldwide. Even with the insurance copayment offered, some families would consider $300 for lifesaving medication a nightmare. This time, the fault lies with the insurance companies, as well as the drug company.

With allergic reactions, it’s either epinephrine or an ambulance ride to the hospital. With epinephrine administered earlier, symptoms are lessened, and the patient will typically require less medical attention. Without that EpiPen on-hand, there’s the cost of the ambulance ride, as well as any costs from the hospital. Insurance companies would have to pay for those hospital fees, which would certainly be over $600, so why would they not pay for the EpiPen? Ironically, this was pointed out by Shkreli himself, saying that “If you’re an insurer, you should love to pay for this stuff.” Overall, the companies spend less money, and people are less anxious about being able to afford epinephrine.

Lately, it’s become increasingly clearer that no amount of outrage from the public can do much to lessen the impact of rising drug prices. Empty promises are thrown around, and after a while, the public calms down, which may be the reason why nothing ever changes: there’s no proactive involvement from the public. Simply put, the public can’t throw a fit for all of two seconds and expect things to change.

Luckily, a recent proposal to add EpiPens to a federal list of preventative services would mean insurances companies are obligated to pay the full cost of the product for millions nationwide. Despite this potential solution, the issue of drug pricing is still in play, and Mylan is still able to charge ludicrous amounts. While some costs are understandable due to the relative amount of work that goes into development, epinephrine has been around for over 100 years, and there is absolutely no reason families should have to pay hundreds of dollars for a life-saving drug.