Stuck With the Bill

Seems to me the Epipen scandal pretty much exemplifies most of what’s wrong with America. Consider:

The Epipen is epinephrine inside  a fancy delivery system.  According to Raw Story, the delivery system was developed by the military on the taxpayers’ dime.  If this is true, one wonders how the pharmaceutical corporation Mylan got an exclusive patent on the thing. If taxpayers developed it, why isn’t it in public domain?

For that matter, EpiPen has been on the market since 1977. Why hasn’t anyone else come up with a competitive product? The only alternative, as I understand it, is to get a vial of epinephrine and a syringe and inject it the old-fashioned way. That might not be practical for some people with extreme allergies that might strike at any time, especially for children.

Epipen’s list price soared to $608 per pack, from about $100 in 2007. Of that, the corporate vampire squid Mylan makes $274. The rest goes to wholesalers, insurance companies, retailers and “pharmacy benefit managers,” whoever they are. Sounds like a whole lot o’ gouging going on.

Note that Mylan has made no significant changes to the Epipen for years. They raised prices, mostly over the past three years, because they expected a generic competitor to come on the market next year, but in fact the FDA did not approve the competitor. So Mylan still has a monopoly.

And there’s this: “For years, Mylan Pharmaceuticals has been selling the devices to schools at a discounted price, giving them a break from rising costs. But the program also prohibited schools from buying competitors’ devices — a provision that experts say may have violated antitrust law.”

And there’s this: “While Mylan was jacking up the price of the pens over the last nine years, making them nearly unaffordable for many patients, the company’s CEO, Heather Bresch, saw her total compensation package go from around $2.5 million when she was the company president to just shy of $19 million in 2015. ”

To add insult to injury, a couple of years ago Mylan re-incorporated in the Netherlands to save itself from paying U.S. taxes, but it’s still mostly located in the U.S.

In most civilized countries this sort of thing doesn’t happen because governments exercise price controls on medicines and medical technology. Companies can make a profit, but only so much profit.  People have been buying Epipen packs for about $100 in Canada, I understand.  Here, as you probably know, Medicare is prohibited by federal law from negotiating lower prices with pharmaceutical companies. Because it’s all about the profits.

17 thoughts on “Stuck With the Bill

  1. Ah, and not to forget the equally fascinating fact that CEO Bresch is the daughter of none other than Sen. Joe Manchin (D? – WV), last heard from when savaging Bernie Sanders back in May for being willing to debate Trump and for “never [having] been a Democrat”. (No comment necessary.) The WAPO did a revealing side-by-side of Manchin’s and Bresch’s parallel climbs to their current positions.

  2. I’ve been against the death penalty my whole life.

    But, I might look away if some people decided to kidnap and “disappear” a few CEO’S FROM SCUMBAG COMPANIES LIKE THIS!

    Let the rest of the CEO’s of the many other scumbag companies fresk-out!

    Let them hide, and sorround themselves with security – AT THEIR OWN EXPENSE! – until they rethink their greedy, grifting ways!

    And then, after they have their “Come to Jesus” moments, release their well-fed, well taken-care of sociopathic scumbag pal’s!
    And then tell the rest, that they, too, could disappear – but that prior performance, is no guarantee of future “returns!”

    I kid !
    I’m just kidding!!
    Of course I am!!!

    I am.
    Aren’t I?
    Just kidding.

  3. I’m surprised there isn’t more kidnapping for ransom going on. I haven’t seen a case reported in America for many years. I’m sure it still happens, but for some reason the six corporations that own 95% of the media think those stories are not worth reporting. I wonder if they’re fearful of giving the lumpenproletariot ideas. After all, if somebody is making nearly $20 million a year their families and near relatives are probably able to raise substantial cash in a short time. Perhaps law enforcement has become so efficient at catching kidnappers that it’s never worth the risk?

  4. Reminds me of the question my history teacher asked me (the best teacher I ever had) why the railroads in the 1800’s could charge a very low price for some destinations and an exorbitant rate on what looked to be a much shorter and easier route. I did not impress him by saying “its their railroad, I guess they could charge what they want”.
    Well then he taught us about government regulation, the commerce clause and competition … I didn’t realize until later that he was teaching us how to think …. missing now!

  5. My wife has to buy two epipens each year. We’re fortunate to have insurance and employment. She came very, very close to death on two occasions, and I can tell you that watching someone you love lose consciousness and fade from the world is an experience that you never forget. So, we pay the jacked up price because they have us over the proverbial barrel.

    I can go down to our feed store and buy a bottle of veterinary grade epinephrine that would contain scores of doses for less than $20. There probably isn’t a dime’s worth of difference between that and what’s in the epipen. Of course, the epipen overs convenience and portability, both of which could be crucial.

    The larger phenomenon provides another reason why capitalism and health care are a bad fit. I bet some other commenters have had this experience, which is similar to the epipen story. — You are prescribed a drug that is simple, cheap and effective. Normally, the pharmaceutical industry periodically “improves” the drug and acquires a new patent to protect its interest and keep the profits rolling in. Many of the improvements are insignificant, apart from the new patent. But, alternatively, the simple drug becomes so cheap that one by one, the producers stop producing it. They move on to other products that are more lucrative. This creates a shortage. So, suddenly, the old generic, time tested, cheap drug is in high demand and the companies that kept producing it can charge what they like. I’ve seen this happen a few times, and it happens independently and irrespective of the value and necessity of having the drug available. It happened with prostaglandin a few years back.

    I’m told that competition is the main innovative engine of capitalism. But, people shouldn’t have to compete over necessities. At that point, people have to choose between possible death or decline, and being fleeced by an army of grifters. The more positive aspects of capitalism are replaced by those that are simply the most profitable, irrespective of benefit.

    Decades of brainwashing regarding market forces, free markets and the freedom of capital seem to have robbed us of the conviction that the modern nation state is a communal project.

    “In Texas, it’s every man for himself.”

  6. We keep epipens around because of having 2 people with severe sudden allergic reactoin conditions in the house. Anaphylaxis is no joke. There is no excuse for these pens costing so much. Jim Wright of Stonekettle Station has a great read posted on this issue. Can they charge these prices? Yes. Should there be a severe backlash against the company and all inversion practices? Yes. Should we stone the insurance companies and their lackeys? Yes. Should Joe Manchin be castigated for having sired such a horrible offspring? Yes. Are we fairly well screwed? Yes.

  7. The odiousness of Bresch aside, the important thing here is that nothing she or Mylan has done is illegal. Which says our system is designed to support such a thing, and not just allow but encourage screwing over consumers. Our society accepts what is clearly immoral because it is legal. If someone has to die so be it; nothing is more important than the ability of some to profit and do so obscenely.

    No matter how you slice it, this is not what any reasonable person would think of as a “shining city on a hill,” a “thousand points of light,” “the greatest nation in the history of the world” or a “Christian” let alone spiritual nation.

    Why do we continue to elect and not hold accountable those who make legal monstrosities such as this?

  8. csm,

    Because for the most part, only the rich and powerful, or well-connect, can run for office.

    And when they get in, they want to stay there, and lobbyists hand over wads of cash, to help them stay in office!

    And then, if they lose, or get bored, or get caught doing something they shouldn’t have done, these politicians can find cushy and well paying jobs with lobbyists.

    And that’s BOTH parties!

  9. Goatherd: You said it very well. When I worked as a nurse, a pharmacy rep made the rounds periodically, provided a free lunch, gave out pens, note pads, etc. And that was just one hospital. I had quite a collection of pens when I retired. Also, the taxpayes do pay for research and development as it is done in the universities that have medical schools. In addition, I have read that big pharma spends much more on advertising than it does on making new drugs.

    Goatherd: Ask and you shall receive:
    Douglas Hughes 62746-007
    FDC Miami
    Federal Detention Center
    PO Box 019120
    Miami, FL 33101

  10. Thanks, grannyeagle,
    But it was me, gulag, asking!
    I’ll write to him over the weekend.

  11. Something to cheer you up, good news from California. Tom Steyer writes in the San Jose Mercury:

    If you want to glimpse the future of the Democratic Party, look at Riverside County, where the number of registered Democrats surged past the number of Republicans. In an historic shift, a county that was solidly conservative “red” for decades seemed to turn Democratic “blue” overnight.

    This unprecedented change is the result of a concerted effort to register and engage as many California voters as possible in 2016. It was made possible by the hard work by community groups, voter engagement organizations, labor unions and the California Democratic Party….

    Yet none of this would be possible without one unwitting ally: Donald Trump.

    His hate-filled presidential campaign has awakened Californians to the hazards of apathy at the polls. Record numbers of Californians are answering the call and registering. Despite the nonpartisan nature of most voter registration drives, Democratic registration is surging, thanks to the Republican nominee’s divisive message….

    …In February, I announced plans for an unprecedented voter registration effort. Our goal: to awaken California’s sleeping progressive giant — the 7 million eligible Californians who don’t vote.

    Since then, my organization, NextGen California, has partnered with more than 40 grass roots voter registration groups in 30 counties around the state. We’ve deployed resources and made grants to expand voter registration efforts from Eureka to San Diego. These efforts have helped make 2016 a banner year for voter registration in California.

    California now has the second-highest number of registered voters in history and the highest number of registered Democrats ever. Yet we are nowhere near done….

  12. Yes, Granny, I forgot about the money spent on advertising. I read about it a while ago too. I may not be remembering it correctly, but, I think some companies spend considerably more on advertising. I’ll have to google it.

    On top of that some companies get the benefit of government research and are still awarded a patent.

    In a discussion of healthcare, a Greek friend of mine once remarked that “Americans turned everything into a business.” As a result, we seem to get a lot of the tail wagging the dog phenomena, especially with the conservative revolution’s adherence to an economic orthodoxy that seems untempered by reality. The purpose of a healthcare system is to provide services to prolong the lives, augment the quality of life and to increase productivity of individuals. Even if you are a confirmed believer in market forces and the efficiency of the market place, some of the failures and contradictions must be glaring. We can have the “best medical care in the world,” but, if only a few can afford/access it, the value of that is diminished.

    Let’s hope that the blinders will fall and we’ll be able to shift to a path that is aimed at being more socially responsible than it is at being true to an economic orthodoxy.

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