When trying to drill down on the Mylan/EpiPen/CEO Heather Bresch story, we’re often told that “it’s complicated.” No doubt it is, considering we are talking about the multi-billion dollar private pharmaceutical industry that is also one of the most regulated in America.
For example, it should be relatively easy to explain the price of a particular drug, but it’s not. As the Wall Street Journal reported last month, “A fragmented U.S. health-care market, combined with a complex system of drug discounts and rebates, makes it difficult to accurately track U.S. drug prices.”
But the heart of the story is not found deep in the tangle of obscure regulations and shareholder dividends, but rather in places like St. Marys, W.Va., where Marty and Melissa Lawhon live with their two children—Brandon, 12, and Preston, 9.
Brandon has severe, life-threatening food allergies; milk, eggs or nuts can trigger anaphylaxis that requires immediate medical attention. “We must carry EpiPens with us everywhere,” said Melissa Lawhon. “It’s a life-saving medication that we must always have. It’s life or death.”
Brandon has a special red bag containing his meds that he is supposed to keep with him all the time.
Recently, the Lawhons’ medical insurance switched to a higher deductible and that’s when they were hit with Mylan’s list price for the drug. “I knew I was going to be paying more out-of-pocket, but I about died when the pharmacist told me it costs $600!”
The Lawhons need three sets a year, and the EpiPens expire after 12 months, so that’s $1,800 out-of-pocket. They can afford it, but Melissa says she worries about families that are not so fortunate.
“I personally know of people who are letting their EpiPens expire, or just don’t get them at all because they can’t afford it. That’s playing Russian roulette.”
Melissa did her own research before the story hit the media, learning that the EpiPen price has gone up over 400 percent since 2007, even though the product has changed very little. “So how is the $600 price tag justified?” she asks. “Then I find out the CEO is making almost $19 million! Something just doesn’t seem right.”
And there’s the story. Something’s not right here. This isn’t the way it’s supposed to work.
Dramatic price hikes for a medicine and a technology that’s been around for decades should not be exploited for maximum profits when the company has a near monopoly and the only alternative for people who need the drug is to risk death.
“I feel like Mylan is capitalizing on a unique situation,” Melissa said. “They’ve got us.”