Cash Price of Epipen ... INSANITY!!!!!

[hedgehog]

I don't know whether to laugh, cry, or cuss over this cartoon.

[CMdeux]

Nurses and pharmacists (here, anyway) can train patients on how to use a syringe to administer medications.  The only problem is that drawing a syringe during a reaction takes precision and fine motor skills, two things people having a reaction may not have by that point.  Cheap, yes.  Excellent option for first responder professionals, yes.  Suitable for parents and caregivers of those with allergies, possibly.  Suitable for self-injection, unlikely.

  This.


I'll also add that it's not necessarily suitable for group care settings of any kind, either. 

[ajasfolks2]

CEO of Price-Gouging Drug Company Could Have Picked a Better Binder to Pose Beside

http://nymag.com/daily/intelligencer/2016/08/ceo-of-price-gouging-drug-company-poses-with-wrong-binder.html

[eragon]

 Have been following this story, very shocking the prices and choices that parents are having to make.

how can one auto injector work for all anyway? From a medical point of view it cant stand. England has the choice of 3 auto injectors, emerade, jext and epi pen.
We currently have emerade as its the only one with a full adult dose and has the advantage of 5 second delivery.  We have used both epi and jext in the past.  Needle length is an issue as well, which is why some idea for different types of auto injector have been refused in UK. Hopefully we will have more choice in time.

We have only paid for our sons auto injectors since he was 18. £8.20  per prescription, all free on nhs from age 2. Our main issue was getting them prescribed in the first place! occasionally we have had shortages, or been given some with short dates on. No one has questioned our need for them with our sons history, and so far we have been lucky to get more than one set in place for school and home. Our GP gave us 2 extra for our long haul flight to USA many years ago without hesitation.

I have been as vocal as possible about this on twitter as I see mylan as being morally corrupt and the idea that parents are faced with living without a vital safety net for their children.     Globally I think other parents in the allergy community should also be as vocal as possible and try to keep some pressure on getting a decent change for american parents and adults who live with life threatening food allergies.

[hezzier]

http://www.fox4news.com/business/196851503-story

Mylan to make a generic epi pen...hmmm? 

[name]

Epigate pierced my insular academic fog.  Had a thing or two to say about it best laid out to the cool heads here even if it unintentionally dog whistles the fringe elsewhere.

Mylan direct and indirect financial support to FARE.  In a monopolistic market failure with no forthcoming transparency, this is not a good thing.  I've read elsewhere folks reading 990s, and FARE's faceless declaration of no more than 5% of budget contribution by Mylan.  Here's the thing: management needs to report faithful material statements including non-financial values.  And whether the audit is internal or external, practices and motivation or influence are still forefront ethical considerations.

FARE has itself in a pickle.  There's no way they are not aware.  I know, I've said so to them directly.  As of now they are in a years long public partnership with Mylan, who by their own declaration are direct financial contributors as well as the dominant corporate sponsor of many events, webinars, and programs that FARE has championed to schools for stock epinephrine.  The corporate cookie jar FARE has its hands in is Aimmune, patented oral immunotherapy.

My prediction now the Grassley is on the move that they will get hit with an antitrust, or if they've soaked up enough Medicare dollars and manipulated the market, a possible FCA complaint if they have a whistle blower along the way.  Or SEC oversight if they've manipulated sales in a way that affects stock price.  I can't even contemplate the likelihood of market entry barriers for competing autoinjectors.  My head will go explody.  Let's just chalk that one up to a screwed up system rather than cutthroat tactics.

Bottom line is FARE needs to align its public face with what it really is these days.  If I were them I'd break up with Mylan and only see it occasionally.  Sell off the Aimmune stock completely, deal with whatever tax situation that puts them in, and move it forward.

I am hopeful this will galvanize the market for competitors, and groom a more responsive FDA to meaningfully engage with manufacturers who already show successful products in other countries (Jext, Emerade, etc.). Oh, and someone buy the license to Twinject to bring it back.  For heaven's sake it's already approved for the US market.

[becca]

http://www.fox4news.com/business/196851503-story

Mylan to make a generic epi pen...hmmm? 

Imagine that!?  After all these years, they can produce a generic in a matter of weeks.  Amazing.   

[CMdeux]

To add to the insightful guest post above (   )

I'd add that one thing that I suspect is that the patent renewal which occurred after the "redesign" was probably rubber-stamped-- and not examined too carefully to see whether it OUGHT to retain that patent protection.... much less new protections on that basis. 

I don't know-- haven't looked.  But it definitely occurred to me and my DH.  That might have been no accident, that 'redesign' that did bugger all to help people actually carry or use the device.  Basically making it 'anti-roll' was about the ONLY improvement at all, there were several 'features' that actually make it worse--and the mechanism is utterly unchanged.

What I don't know is when the original patent protection was set to expire (before then).  My hypothesis is that it was sometime between 2010 and 2015.   



Thanks, also to Eragon and other other non-US members who have pointed out just HOW awful this is compared with other countries.  Morally bankrupt is about the only way that I can think about this industry and what it does to the US population that pays so much for it's R&D budgets to begin with.  It's outrageous.  To a point that leaves me frankly speechless. 

This technology cost the pharmaceutical companies that have held the patent almost nothing to develop.  To MONETIZE, sure-- they had to go through the FDA for that, so yeah, lawyer-fun-times.  That cost, those applications. 

But the device itself was already paid for and WELL-developed for use with atropine.  By the military-- er, or the research that supports innovations in the military, that is.    The armed forces and space program both work this way-- when technology is not considered tactically advantageous to keep classified, then it becomes fair game for intellectual property transfer... and so it was with pre-determined dosing, autoinjection devices. 

Narcan and Epinephrine were pretty obvious candidates, since dosing is reasonably standard "per person" in emergent situations. 

All of that adds up to what SHOULD have been a robust market all along, with respect to generic devices.  Blame our patent protections for pharmaceuticals.    

[rebekahc]

I wonder if it would be possible (for sure it would be cost-effective in the long run) to order a vial of epi and make your own ana-kit type setup except with an autoinjector.  Something like this:
http://www.unilife.com/product-platforms/auto-injectors/lisa-auto-injector

[spacecanada]

Interesting link, Rebekah! I like the idea of reusability and less waste, but not super keen on how it relies on electronics, which probably means battery life will be a concern. Still, a very innovative device.

[CMdeux]

I wonder if it would be possible (for sure it would be cost-effective in the long run) to order a vial of epi and make your own ana-kit type setup except with an autoinjector.  Something like this:
http://www.unilife.com/product-platforms/auto-injectors/lisa-auto-injector

The problem with this--- and this is the precise problem with vials of epinephrine-- is that epinephrine is stable for literally only a few HOURS when drawn into a syringe under exposure to air. 

[hezzier]

http://chicagotonight.wttw.com/2016/08/29/allergist-mom-says-mylan-should-lower-cost-epipen

[aggiedog]

I haven't posted here in Main forever, but this whole epi-pen thing makes me crazy.  Aside from the fact that the price increase is, as CM says, morally bankrupt, it amazes me that they 1.) increase the price 3 fold or more, 2.) magically create a generic over night, that is 3.) still more expensive than the branded epi started out at.  It's like bait and switch - we'll make it so expensive that when we "discount" it, they'll never realize they're still paying thru the nose!

I'm not buying it.

[Macabre]

I just miss the AuviQ so, so much.

[Name]

What worries me is the dearth of competition in the US market--for reasons other than obvious choice.  Should there be a fact pattern that points to significant market manipulation that bled over to accounting gymnastics inflating revenues artificially, then they are in much deeper doo-doo then they could ever imagine.  Worse, if there is evidence of any heavy exercise of stock that might indicate insider trading coordinated with market manipulation. 

With this monopolistic production, no matter if it were the worst of the worst corruption, that product must continue to be manufactured because there are no comparable substitutions given schools have been groomed to demand branded EpiPens to use on students.  It's what they will be trained to.

And, while we may or may not find out exactly how much total support or sponsorship FARE has from Mylan, neither will we know in an actionable timeframe which and / or how many executives from FARE over the years held Dey or Mylan stock.  Certainly we know past FARE chief executive officers have hailed previous executive positions in Dey.

Mylan producing its own generic is not competition, nor does it address business practices.