Outrage over EpiPen price hikes has the company’s owner scrambling

Mylan’s response is unlikely to satisfy many of its loudest critics.

CREDIT: AP Photo/Mark Zaleski, File
CREDIT: AP Photo/Mark Zaleski, File

Following rapidly escalating outrage over dramatic price hikes to the EpiPen, a device that administers emergency allergy medication, pharmaceutical company Mylan announced on Thursday that it will lower EpiPen’s price—but only for some of its consumers.

In a press release, the company said that it will offer a savings card to patients covering up to $300 of the cost — half of the full $600 price of a 2-pack of EpiPens, which is currently the only way the devices are sold. Mylan already offered a so-called “$0 co-copay” savings card to consumers, but the card previously maxed out at $100 dollars, leaving customers without insurance or with high-deductible plans on the hook for hundreds of dollars.

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Mylan also announced that it will double the eligibility for a patient-assistant program, which, if applicable, “will eliminate out-of-pocket costs for uninsured and under-insured patients and families as well.”

In her comments, Mylan CEO continued to put the blame for the rising cost of EpiPens on the insurance industry and the spread of “high-deductible” insurance plans, which require patients to pay high out-of-pocket costs.

“We have been a long-term, committed partner to the allergy community and are taking immediate action to help ensure that everyone who needs an EpiPen® Auto-Injector gets one. We recognize the significant burden on patients from continued, rising insurance premiums and being forced increasingly to pay the full list price for medicines at the pharmacy counter,” she said.

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However, while the steps may indeed ease the burden on some patients, Mylan’s response is unlikely to satisfy many of its loudest critics, as the list price for EpiPen remains unchanged.

“There’s only one course of action: actually lower the price.”

Since Mylan purchased the rights to the auto-injector — which safely and easily delivers a dose of the hormone epinephrine (adrenaline) to keep airways open during a life-threatening allergy attack — the price of the EpiPen has increased by 450 percent, despite no noticeable improvements to the technology. That puts an expensive burden on patients: EpiPens must be replaced every year, and people with allergies are often told to err on the safe side by owning multiple sets.

“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,” Robert Weissman, the president of Public Citizen, a consumer rights group, said in a press release in response to Mylan’s announcement.

The actual dosage of epinephrine delivered by the injector costs about $1.

Outrage over EpiPen’s exorbitant cost has quickly spread over the past few weeks. News reports quickly sparked consumer outrage; then, the issue captured the attention of Congress and eventually made its way into the presidential race.

Sen. Amy Klobuchar (D-MN), whose daughter uses an EpiPen, blasted the company and urged the Judiciary Committee to investigate the price increase. Senator Chuck Grassley (R-IA), the chairman of that committee, sent a letter to Mylan’s CEO Heather Bresch (herself the daughter of Democratic Sen. Joe Manchin), and a bipartisan group of five senators wrote to the FDA requesting information about the development of a generic version of an epinephrine auto-injector. (The FDA rejected a bid from Teva Pharmaceuticals to make a generic version earlier this year.)

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Meanwhile, Sens. Claire McCaskill (D-MO) and Susan Collins (R-ME), leaders of the Senate Special Committee on Aging, wrote to Bresch to request a briefing on the issue “at a mutually convenient time no later than two weeks from” Wednesday.

The White House also weighed in on Wednesday. Press Secretary Josh Earnest said that while he wouldn’t comment on a specific company, the price hike “raises significant questions, even moral questions, in the minds of a lot of people.” The same day, Democratic presidential nominee Hillary Clinton said that Mylan’s actions were “outrageous — and it’s just the latest troubling example of a company taking advantage of its consumers.”

Bloomberg Business first reported on the exorbitant cost of EpiPens in September 2015.

While Mylan’s proposed changes may alleviate some of the cost to individual patients, the high-list price will continue to place a burden on the health care system, thus passing the cost on to consumers and taxpayers.

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The high cost of the injectors, which have very little competition, will continue to affect entities such as hospitals and EMTs. Crippled by the costs of the devices, some counties are pushing to train EMTs to use simple syringes of epinephrine instead of the branded auto-injectors.

According to reporting from Bloomberg, the EpiPen is a billion-a-year product for Mylan and provides a large share of the company’s operating profits.

Mylan’s hugely profitable EpiPen business is driven by two factors: continued price hikes, paired with a huge marketing campaign aimed at expanding the number of patients eligible for the device and at getting EpiPens stocked in public areas, like schools — an effort boosted by a legislative push following a child’s death from an allergic reaction at a Virginia school. (Allergy deaths are actually quite rare — about 186 to 225 deaths per year. For context, over 4,000 Americans died by choking in 2014, and in 2015, over 38,000 Americans were killed in motor vehicle crashes.)

In its press release, Mylan also points to its EpiPen4Schools® program, which provides free or discounted auto-injectors to schools. A report from STAT, however, found that this program also contained a stipulation requiring schools to only purchase brand-name EpiPens, possibly violating anti-trust law.