Free EpiPens at Mylan’s West Virginia Retreat by Pat Conrad MD

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Down here on the gulf coast, we get the occasional storm this time of year, oftentimes followed by rumors and local news stories about price-gouging over gas, ice, and chainsaws. Generally the insects get all stirred up, and there are more bee and wasp stings. While I haven’t seen any spike in anaphylaxis cases, having an extra EpiPen or two around the house would be a reasonable – if expensive – precaution for those so pre-disposed.

By now we have all read the news about the surprise – SURPRISE! – price jumps for the EpiPen. The drug manufacturer, Mylan, has jacked the price a total of more than 400% since 2007, the latest increase being 15% just 2 months ago. Mylan’s CEO is Heather Bresch, a now fashionable target, who had her MBA yanked by the University of West Virginia, because, well, she didn’t earn it tax-sheltered Mylan off to the Netherlands; and got a 671% salary increase over the last eight years. “She was recently elected to head the board of directors of the Generic Pharmaceutical Association, whose mission is to help patients gain access to affordable, high-quality meds.” Really? And of course, Bresch’s dad is U.S. Senator Joe Manchin, who was the governor of West Virginia in 2008 when Bresch didn’t earn her degree that she received, through an Executive MBA program, funded in part by Mylan, whose chairman then was a huge Manchin supporter (and his $20 million donation got his name on the West Virginia Mountaineers football stadium).

Connecticut Senator Richard Blumenthal (D), Democrat of Connecticut, has written to Bresch, “calling for a congressional and federal investigation and demanding to know whether Mylan exploited its “virtual monopoly” on the device.” When running for Congress in 2010, Blumenthal lied about serving in Vietnam, claiming later that he “misspoke.” President Clinton’s Wife, who once lied about being under sniper fire, is “outraged” over the EpiPen price increases. Her staunch supporter Sen. Manchin famously won election by opposing ObamaCare, going so far as to shoot a copy of the legislation in a 2010 campaign ad. Every time the Mountaineers win a significant game, they all run out and burn discarded couches on their lawns. So it’s all connected.

What about the EpiPen? It was first invented in the 1970’s, now costs somewhere less than a couple of bucks to produce, and is obviously life saving. Its availability deserves more ire than say, cancer drugs, only because it can be immediately death preventing. “Bresch says high EpiPen prices are necessary to pay back the company for the expensive investment it’s made in the device. She adds that the health insurance industry is also to blame, calling its raising of fees that consumers have to foot “unconscionable.” Those fees include skyrocketing deductibles – Hello ObamaCare! – that will leave the middle class anaphylactoids gasping. In 2007, Mylan was making about $200 million on EpiPens; in 2016, they will take in over $1 billion. In 2013 Pres. Obama signed legislation to promote supplies of “undesignated” EpiPens in public schools (which Mylan now uses to justify its price jacks). The company is now offering coupons that will discount the price of a 2-pack by about $300.

While lower-cost alternatives are speeding in the pipeline, there is an argument that for the present Mylan has a virtual monopoly. I don’t pretend to understand monopoly law or logic, when one intellectual property may be bought and sold in perpetuity, while another has a limited shelf life. Didn’t the inventors, investors, and perfectors of the EpiPen earn a fat hog to cut? I think the hardware store owner who doubles chainsaw prices the day after a hurricane is engaging in extremely poor long-term marketing, but it is his right to participate in dynamic market forces.

There are lots of the guilty here: For all their outrage, Pres. Obama, Mrs. Clinton are the ones who enforce an anti-business culture that has corporations logically setting up overseas offices to escape punitive taxation. And in encouraging the crony corporatist theft by the insurance companies, they have both given an excuse for driving up deductibles, and cover for schmucks like Mylan. Ms. Bresch is clearly the corrupt scion of a corrupt culture, a horrible figurehead for corrupt corporate ethics, and in all appearances a self-absorbed, dishonest jerk whose PSA’s for anaphylaxis are pretty cheap window dressing compared to a $600 EpiPen pack. As when the Feds encouraged the banking malfeasance that led to mortgage-backed securities, so now they have encouraged slimy misbehavior by Big Insurance and Big Pharma. And yet none of this gives anyone a right to an EpiPen anymore than they have a right to a chainsaw. It would just be nice to see, as with gouging hardware stores, that the victims keep a longer memory after the storm has passed.