- - Tuesday, June 13, 2017


The mainstream media routinely mistakes the firefighter for the fire.

Emblematic has been the frenzy over the consumer cost of Mylan’s EpiPen® Auto-Injectors to treat life-threatening allergic reactions.  Mylan has been demonized as a profiteering, heartless pharmaceutical company that has jumped the consumer price of EpiPen fivefold over a decade to $600.00. But that airbrushed pricing picture is like appraising the aesthetic s of the Taj Mahal by examining a single brick.  

At present, the wholesale acquisition cost (WAC) of Mylan’s generic version of EpiPen® Auto-Injector is $300.00, the lowest generic on the market.  The WAC for its branded version is $608.00.  The WAC charged by Mylan’s competitors are substantially higher:  $4,500.00 for Auvi-Q ®; and, $395.21 for the Authorized Generic of Adrenalick ®.

Mylan offers a $300 savings card for EpiPen ® Auto-Injector and a $25 savings card for its authorized generic.  Uninsured patients earning up to 400 percent of the federal poverty level pay nothing for EpiPen® Auto-Injector, including uninsured or underinsured families of four making up to $97,200 annually.  The entire EpiPen® Auto-Injector pricing picture-including the authorized generic— shows that 90 percent of consumers are incurring out-of-pocket costs of less than $100.00, and that more than 80 percent are paying less than $50—or less than 10 percent of the media ballyhooed figure of $600.

That latter number is not wholly imaginary. But President Barack Obama’s Affordable Care Act is the serpent in the health care paradise that gave it birth.  For every action there is an equal and opposite reaction.  Obamacare’s crushing health insurance mandates caused more employers to choose high-deductible plans to lower monthly premiums.  The percentage of workers enrolled in high-deductible employer-sponsored plans linked to a health savings plan account climbed from 4 percent in 2006 to 20 percent in 2014 to 24 percent in 2015.  

These plans characteristically require enrollees to pay the first $6,000 of health care expenses before insurance starts to pay.  The enrollees in these plans thus began paying the entire $600 WAC for the EpiPen® Auto-Injector until their deductible ceiling had been reached.  

Relatedly, insurance companies also began to hike the co-pay share of health care expenses to offset Obamacare’s upward pressure on monthly premium payments.  The co-share payment for the Epi-Pen® Auto-Injector jumped accordingly.

The portion of Mylan’s Epi-Pen® Auto-Injector consumers who are experiencing an unpleasant jolt in price, however, is a small fraction of the whole.  Moreover, there are no artificial entry barriers into the epinephrine auto-injection market.  Anyone who can build a better mousetrap at a lower price is free to capture Mylan’s customer base and drive it out of business with skill, foresight, and industry.            

In any event, Mylan has not been sitting on its laurels.  Since 2008, it has invested more than $1 billion in raising awareness and expanding education about the risks of anaphylaxis, an acute allergic reaction to an antigen like a bee sting to which the body has become hypersensitive.  Mylan has championed laws to permit student access to epinephrine irrespective of brand to protect children who may have experienced an anaphylactic event.  It has distributed without charge more than 850,000 EpiPen® Auto-Injectors to schools across the United States through its EpiPen4Schools program.   

In sum, Mylan is the firefighter and not the fire in treating life-threatening allergic reactions.  Don’t let the media mislead you.

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