EpiPen:
Profits, Not Life

Sep 5, 2016

EpiPen made the recent news when its manufacturer Mylan increased its price to more than $600 for two injectors, enraging the patients who need this drug to deal with life-threatening allergic reactions. This rage is very justifiable considering that the same EpiPen dose is sold by a company in France, for about $85 a pair. Another French company ALK-Abello, which specializes in allergy therapies, sells the Jext pen for $34 to $67 throughout Europe.

This rage is also highly justifiable since people can die very rapidly due to a severe allergic reaction called anaphylaxis if the drug, epinephrine, is not injected right away by using the EpiPen injectors. Anaphylaxis can occur within seconds or minutes of exposure to an allergen, something like a peanut or the venom from a bee sting, according to the Mayo Clinic. If anaphylaxis isn’t treated right away, it can cause shock, with blood pressure dropping suddenly and a person’s normal breathing blocked. This medical condition can lead to unconsciousness or even death.

Such allergic reactions send more than 200,000 people to the emergency room every year, causing between 63 and 99 deaths yearly. A doctor can inject epinephrine without needing a special injector. The EpiPen, containing this drug, is easy to use: no need for any training, instructions are clear. The patient or any person nearby basically can jam the device’s needle into the patient’s thigh and inject the drug.

Because of the risk of death in cases of anaphylaxis, doctors wrote 3.6 million prescriptions for EpiPens last year, according to the Wall Street Journal.

The drug epinephrine is a human hormone, first isolated by Japanese scientists in 1901. The auto-injector used by EpiPen was developed in the 1970s by a NASA engineer. It was designed for the rapid self-injection of antidotes to chemical warfare agents used in battle. In 1987 it was approved by the FDA for use with epinephrine.

So, Mylan, the company that manufactures the EpiPen, neither invented the drug nor the injector. These have been available to the public for many years. Mylan does not manufacture epinephrine. Mylan doesn’t even manufacture the injector. Pfizer manufactures the injectors based on the NASA engineer’s original design.

What Mylan did was simple: it cornered the market. EpiPen is the only epinephrine injector approved by the FDA. Mylan first acquired U.S. marketing rights from Merck in 2007, when the auto-injectors cost around $100 a pair. Now Mylan is charging about $600. This is a 500 percent increase in nine years.

In addition, Mylan lobbied the federal government to increase sales of the EpiPen. In 2013, Congress passed the School Access to Emergency Epinephrine Act, which, in essence, forced every school to have epinephrine available.

Mylan used every opportunity to its advantage. Mylan was based in suburban Pittsburgh. Last year, Mylan relocated the company on paper to the Netherlands to evade U.S. taxes, thanks to the treaty negotiated by the U.S. government with the Netherlands.

By monopolizing the market, pumping up the EpiPen price, using every legal and tax loophole, Mylan has made more than one billion dollars a year from the EpiPens.

When these schemes were mentioned to Mylan’s CEO Heather Bresch, daughter of a U.S. Senator, she explained, with a straight face, on Aug. 25: “It was never intended that a consumer, that the patients, would be paying list price, never. The system wasn’t built for that.” So, Mylan is asking the taxpayers to pick up the bill. But, the taxpayers and the patients are the same people. They are the workers who make every product, including Mylan’s EpiPen, who suffer from various diseases and pay taxes.

But, Mylan is not the only company that profits at the expense of workers. Prices of generic or brand name drugs–manufactured by giant pharmaceutical companies, like J&J, Merck, Pfizer, Teva and Bayer–skyrocketed in the last 10 years. These companies corner the market using one scheme or another to rob us all, even sometimes shortening our lives.

This is how capitalism organizes medicine.