I’m referring to drug companies, after reading this “extraordinary commercial response” from Mylan (that’s their own self-glorious rhetoric, by the way) in dealing with a series of obscene price rises for a live-saving product they acquired.
For anyone who doesn’t know, an EpiPen is a device used by people with severe allergies to give themselves a shot of epinephrine/adrenaline if they ever have an anaphylactic attack. It is a sterile ampoule of the drug with a spring loaded needle, and is based on devices developed by the American army to treat nerve gas attacks quickly. In short, it saves lives.
The EpiPen was first marketed in the mid-70s. It has been successively owned/part-owned/marketed and generally thrown around by various large pharma companies. Mylan got their hooks into it in 2007. Every time anyone else develops something even remotely similar, it seems that they’re sued to hell and back, and it’s so bad that any attempt to save someone having an anaphylactic attack without using an EpiPen is virtually an infringement of patent. You can read the extremely dark and disturbing history on Wikipedia.
But here’s the worst part. Up until 2007 in the USA, a pack of two EpiPens cost around $100 (note that they have a 12-month shelf life, so a user would be looking at spending the same amount each year just so they always had a back up). Even that price was bad enough, since only about $1 of drug is contained in each EpiPen. However, largely following a push by Mylan the market share of the EpiPen rose higher and higher. In spite of selling more and more units, Mylan increased the price successively, passing $265 in 2013, $461 in 2015, and more recently to and absolutely obscene $609 (it has gone up by 500% since Mylan acquired it in 2007).
Laughably, Mylan’s cheaper generic version which they are touting costs a “mere” $300. Just a reminder that it delivers $1-worth of drug. Indeed, you can purchase a 1ml ampoule of epinephrine for about $5 retail.
If you take a look on Amazon, auto-injector pens for Insulin cost around £40 (just over $50) for all-singing-and-dancing models with electronic memories. The EpiPen is a cheap plastic throwaway device. Mylan has no excuse whatsoever for the price it is asking Americans to pay.
It’s understandable that pharma companies charge high prices for brand new medicines because it costs many millions of pounds/dollars to develop them. It is also understandable that medicines which have a fairly low user base are also more expensive. But sometimes, the price asked is just too much – especially when it is hiked from an established low price to a much higher one, usually following the purchase of the marketing rights by a no-name company. Many years ago my mother asked me to buy her a tube of special ointment which she had previously been prescribed. It was available through the pharmacy and didn’t actually need a prescription – except that a small 5ml tube retailed at £45. She went to the doctor to get it instead. But this was chickenfeed compared to some of the borderline criminal pricing that goes on.
A few years ago there was an outcry when Martin Shkreli, CE of Turing Pharmaceuticals, raised the price of Daraprim from an established price of under $14 per tablet to $750. Daraprim was suitably “hot” in that is was used to treat certain conditions associate with HIV/AIDS, and before Shkreli could be lynched outright for this particular situation, he was indicted for fraud on unrelated issues (note: only “unrelated” in the legal sense, since there was clearly a link in terms of Shkreli’s morals).
Rodelis Therapeutics acquired Cycloserine, used to treat drug-resistant tuberculosis. They immediately raised the price from $500 for 30 tablets to $10,800.
Valeant Pharmaceuticals acquired heart drugs Isuprel and Nitropress and promptly increased the price of Isuprel by 525% and Nitropress by 212%.
Marathon has raised the prices of various drugs it acquired from others by a factor of four.
Doxycycline is a tetracycline antibiotic. It cost as little as $4.30 for 30 tablets in 2012. By early 2013 it was sitting at $165 for the same amount. A bottle of doxycycline was around $20 in late 2013 and yet it was $1,849 by April 2014. Mylan appears to be involved in this one again.
In the UK it can be just as stupid. Paracetamol tablets cost as little as 14p for 16 tablets (0.88p per tablet) retail. Certain companies who manufacture them, and who sell them as branded items, have asked up to 75p for 16 tablets (4.69p per tablet) and even now ask 50p. The NHS is paying between two and twenty times the lowest retail price, depending on which news source you believe. And yet all paracetamol tablets labelled as “Paracetamol BP 500mg” are identical (even if they’re labelled “caplets” they’re still essentially the same and very cheap to make). Although it has been a long time since I was involved, you can believe me when I say that the cost price of each tablet/caplet is tiny. Even 14p for a tub of 16 is profitable except to dinosaur companies with ridiculous overheads.