By Jason Poquette, BPharm, RPh
Drug manufacturer Mylan Labs has come under severe fire lately for the steep price increases for their prescription-only product known as the EpiPen®. The EpiPen®, a life-saving auto-injection of the drug epinephrine, is used by children and adults at risk of anaphylaxis from severe allergic reactions caused by things like insect stings or food allergies. The EpiPen® is intended to be carried in case of emergency by at-risk individuals. The full retail price for this medication has risen from about $100 in 2007 to over $600 today.
The price of the EpiPen® has risen over 500% over the past decade, mostly through incremental increases which have become more frequent recently. “There does not appear to be any justification for the continual price increases of EpiPen®,” wrote Senator Amy Klobuchar (D-Minn.) in a letter to the US. Federal Trade Commission.
“Not only is this alarming price increase unjustified, it puts life-saving treatment out of the reach of the consumers who need it most…some people are being forced to carry expired doses of EpiPen®, hoping the product will work past the expiration date.”
One explanation for the large price increase is the lack of a suitable alternative to the EpiPen® on the market. A potential competitor product known as the Auvi-Q® was withdrawn from the market over a year ago due to a faulty delivery system. Another competitor that remains on the market, known as Adrenaclick®, is generally considered an inferior device and not as widely covered by insurance plans.
Mylan has responded to the political outrage by insisting that their efforts to make EpiPen® widely available and affordable justify the pricing strategy they have followed. According to the Wall Street Journal, “Mylan pointed to a statement saying it was committed to ensuring patients have affordable access to the drug, and the company has given away more than 700,000 EpiPens to schools while paying all the out-of-pocket costs of 80% of commercially insured patients.”
What Mylan is referring to, with respect to paying the out-of-pocket expenses, is their copay reduction coupon which is available online on their website. Patients with standard commercial insurance (i.e. not a Medicare-D plan or other government funded plan) can download this coupon and bring it to the pharmacy to cover up to $100 of their copay. In states like Massachusetts where a greater percentage of the population has some insurance coverage, this copay card is very helpful.
But such efforts by the manufacturer to defray the patient costs of the drug are not enough to hide the fact that its own profits have soared through the pricing hikes they have initiated. For example, it has been noted that Mylan CEO, Heather Bresch, has had her compensation package grow from $2,453,456 to $18,931,068 during the 2007 to 2015 era in which Mylan obtained the rights to EpiPen® and has been steadily increasing the price. Mylan’s stock has enjoyed the revenue increase as well, moving from less than $15 in 2007 to over $45 in 2016.
In response to the negative publicity over the price increases, Mylan Labs has just announced that they will increase their assistance program to cover up to $300 for eligible patients and provide free product to more families who qualify. But some critics say it isn’t enough.
While the price wars go on, as a pharmacist it is important to me, and my colleagues in this profession, that patients who need the EpiPen® can get it and know how to use it appropriately. Note that every EpiPen® 2-pack also comes with a “trainer” pen that has no medicine and should be practiced with prior to needing the real product. Patients should store the product at room-temperature and avoid exposing the pens to excessive heat. Watch the expiration date and replace as needed. And finally, be sure to take advantage of the $100 copay reduction coupon (found online) to help defray some or all of the price.