I was wondering when this would happen.
http://www.local10.com/news/national/epipen-outrage-may-fuel-cheap-generic-in-2017
The sooner the better! We have lots of food allergies and have never had to use an epic-pen. It makes you a bit complacent though, which is dangerous. How nice it would be to have fresh ones around and not worry about the hideous cost.
Thank goodness. Sooner the better. The outrageous price increases over past years is ridiculous.
mylan the epi- pen manufacture has announced they also are releasing a generic epi pen (I believe it will be sold at 1/2 price)…but if teva a competitor does it as stated in the article it will be better for consumers.(monopolies are never good) I have watched an epi pen used and it is a miracle.(instant visible response) it can be the difference between making it to the ER or not with anaphylaxis.
So Mylan would release its own generic? What would be different? The box isn’t as pretty?
Hope Teva does better.
The difference is going to be in the delivery mechanism and the formulation; so ease of use and shelf life maybe significantly different.
I watched the interview of Mylan CEO on CNBC. The Mylan CEO is no dummy - not to be confused with the greedy Pharma Bro. She is hoping to bring to light the hidden cost of drugs in the US - the cost of the supply chain.
Why can Costco sell 10 warfarin syringes for $225, and why does a pack of the same (!) 10 syringes at RiteAid cost almost $800? Who pockets the difference?
The other possibility is to give folks a syringe, and vial of epi, which costs around $5.00. Yes, all of that other $495 is the cost for packaging and delivery system, as well as excess advertising. It is a bit more of a project to learn to use. However, the cost as it stands is prohibitive and I’m sure many are going without. Heck, I resented the epi pen $25 copay yearly x2! http://abc22now.com/news/local/epinephrine-injection-kit-for-under-10 I had asked for this for my peanut allergic daughter. Having had allergy shots, I know she could learn to use it. Why she does not have it is complicated, and the allergist stated he’d have to talk to the practice attorney for the clinic. A school nurse could give it, however school kids still need epi pens for field trips and so on.
Bunsen, I’d think you meant Enoxaparin, which is used to bridge the clotting times till the oral warfarin blood levels return with a high enough level of anticoagulation. I had no clue there was such price variation in that drug as well. Costco might have bulk purchasing? Still…
Frankly, I wish advertising for prescription drugs was banned. Who is it benefiting? I’d love to know how much of the costs of new meds are advertising related. If nothing else, what 7 year old needs to know that ED can be an issue?
“Yes, all of that other $495 is the cost for packaging and delivery system, as well as excess advertising.”
“Packaging and delivery system” can mean a difference between life and death, just to make a note. Not everyone is able to carry a vial and a syringe and take quick action when needed. However, it is not what is going on here, and it is not advertisement either. There are several hidden middlemen that take the cut before the drug reaches the patient, so it is incorrect to oversimplify the issue as ad costs.
RiteAid is a large chain whose main business is pharmacy, so you would think they would negotiate discounts similar to what Costco would be able to leverage. Or at least charge a bit more. But 3.5X?! Nothing sold at Costco costs that much elsewhere.
Costco’s profit comes entirely from membership fees. They cut everything else to the bone.
I know that very well. My point is that even if we assume that Costco is selling its drugs at 0% profit (which it is not), why can’t others sell these drugs marking them up a mere 100%? Is the 350% markup justified and by what factors?
No, the CEO is no dummy, but she also is being more than a little bit disgenenuous when she blames the supply chain. There is no doubt that what drug chains charge varies all over the place, and I won’t even say they don’t engage in price gouging. However, that still doesn’t explain Mylan jumping the wholesale price they charge to the levels they have, this has nothing to do with supply chain. The Epi Pen is a mature technology as a delivery system, it was developed a long time ago so the cost of developing it, the cost of getting it past testing, are well in the past, they are sunk costs. Sure, there is a cost to manufacturing the item, there are both fixed and variable costs I would assume, but have their costs gone up that much more? Or did they see a situation where for whatever reason they had a monopoly, and decided to take advantage of it to boost profits?
Synthesizing Epinephrine itself dates back to the turn of the 20th century (a marvelous story recounted in the book “Proof”, the guy who did it had an interesting history, one of the few times the nice guy didn’t get the shaft), so it isn’t like this was some modern miracle drug requiring years of trials and development work the way they would with a new antibiotic or cancer treatment.
So what is their justification, other than taking advantage of people? Most of their cost for the product would be in marketing, packaging and promotion, I have no way of knowing what the cost per unit is, but given what it is, I have to wonder if it is more than a few bucks, given the maturity of the compound and the components of the packaging (a friend of mine who has worked in the pharm industry as a research chemist said he doubted it cost them more than 5 bucks/unit to produce). From what I see, they had a monopoly, no competition, and did what monopolists do, raise prices.
And she may be no dummy, but she also tried the old game of pulling the wool over people’s eyes. When she blamed the supply chain, there was some truth to that, maybe they should have negotiated better prices, but when she said people were not paying any more (then blamed the copays insurance companies put on patients), it leaves out a big cost,that when drug prices go up to insurance companies they end up raising premiums, which in turn ends up with people either paying more, losing insurance or having companies because of the cost of insurance not giving raises. When they raise prices whether the end user sees it or not isn’t the point, someone is absorbing that cost, and drugs are a big part of the cost of health care.
“The Epi Pen is a mature technology as a delivery system, it was developed a long time ago so the cost of developing it, the cost of getting it past testing, are well in the past, they are sunk costs.”
Listen to the interview in its entirety. According to the CEO, Mylan did more than just repackaging an existing product. There was an investment made into the improvement of the injector and the formulation. I do not have the time to research to what extent the product was improved, but if it is true, it is not a direct analogy to the Pharma Bro case where the guy simply raised the price without doing anything.
The supply chain has never been blamed on any of the costs increases… Only the manufacturers. They both share the responsibility.
I don’t doubt the supply chain is involved at all…that said, though, she was disigenuous when she said the price rises had little impact on people, she also blamed rising co-pays from insurance companies for why people paid more for epi pens, without mentioning how much the wholesale price they charged went up.
Likewise,I am very dubious that their costs on Epi Pen justified a wholesale price increased of several hundred percent, without specific details of what they actually did I cannot say how much it cost them, but it would take them opening up their books on the costs and having them vetted by professionals, . I would love to see the extra cost (which since it gets written down as an R and D expense and comes off their taxes in the form of deductions and tax credits, so is subsidized) and see if it justifies a several hundred percent increase. It more sounds to me like Cadillac taking a Chevy Cavalier, tarting it up with leather interior, special wheels and so forth, and selling it as a “Cimmarron” and charging twice as much for it ie it mostly was tarting it up to try and justify the higher price shrug. Is this the same thing Shvelli did? Probably not, but if not the same thing, it is its wicked cousin.
but when she said people were not paying any more (then blamed the copays insurance companies put on patients)
That is something that really sets me off. I had a billing person say something similar recently (“Well, you don’t pay the cost - you just pay your copay”). Um, duh. In my case, I do pay it (because I have to pay for the first so many thousand dollars before coinsurance kicks in) … but regardless of whether I pay directly or my insurance company pays, it is getting paid. Since H’s company’s insurance policy is self-insured, you bet your sweet life I am paying for it … one way or another (lost raises, etc). SOMEONE PAYS, LADY!
^^Proves my point precisely. The public is outraged - but only by what is visible, i.e., Mylan. It is easy to blame the greedy manufacturers because we all know where the product originates and where it ends. But where and how it travels between these two points is a black box to the consumer. The invisible middlemen that take a huge chunk of what the patient pays… stay invisible and continue their conduct.
I am not trying to defend the Mylan’s pricing, just pointing out that there is more to the story than the headlines make you think there is.
I think it’s absolutely horrific that people are going to go without epipens because of this hike, but I’m also glad that the “hidden” costs of health care that is just ridiculous.
Most people will never really know how much their bill really is because they just see the copay. Like my “free” infusions are billed at over 10k a pop. That’s ridiculous but I only know this because I’m intensely fascinated by our health care system so I go over my EOBs carefully.
" It more sounds to me like Cadillac taking a Chevy Cavalier, tarting it up with leather interior, special wheels and so forth, and selling it as a “Cimmarron” and charging twice as much for it ie it mostly was tarting it up to try and justify the higher price shrug. Is this the same thing Shvelli did?"
Again, I am not saying that the huge price increase is justified, but I am very skeptical that it is just a color of the package and other minor changes like you are implying with your car example. It will take more than a few minutes to do a few searches to see what changes have been made, so I am not going to engage in this exercise at the moment. But if you have some time, please report back your factual findings to back up your Chevy comparison.
And if tax writeoffs was all it took for companies to invest in R&D, the cancer would have been cured by now!
http://www.canadapharmacy.com/index.cfm/fuseaction/product/name/Epipen/product_id/1959.htm
You can get a 2-pack from Canada pharmacy for $168. That is lower than my deductible. Something is fishy here… this is a “brand” drug BTW, not a generic.
I’m old enough to remember the big pharma giveaway by Congress, largely orchestrated by Rep. Billy Tauzin who went on to leave Congress and get a cushy job in the pharma industry. Medicare is not allowed to negotiate prices on drugs - that was just one of the prizes we (our reps) gave away. Now we have this, and many other drugs that we get to pay more for. I tried to use my FSA credit card to buy from Canada Pharmacy once and it “wasn’t allowed”. Basically, we are not allowed to do anything except spend more on drugs! Thank you, you crooked bastids.
I have been reading about this in the news and have been a bit confused by the statements that there are no generic versions available. We are with Kaiser and they switched a few years ago from the Epi-pen to a generic auto-injector made by Lineage Therapeutics. I am looking at the package now and it states that it is a generic version of Adrenaclick. So with the switch, the price for our co-pay dropped from $50 to about $10. Hence, my confusion about there being no generic version. The only difference I can tell is that the Epi-Pen works like a pen - you jab it in the thigh and depress the button. Whereas this auto-injector is just a needle looks kind of about the same, however you jab it in the thigh without needing to depress the button, just hold it in place for 10 seconds. We’ve never actually had to use it (there was one occasion when we took my son son to the emergency room where we definitely should have used it first), but this generic version seems as if it would be just as effective. What am I missing?
The earlier version of the Adrenaclick was discontinued in 2013. Maybe that’s why doctors don’t think of it as much.