Pharmaceuticals are big business, and that has many asking if the companies producing them are placing profits before patients. Last year pharma exec Martin Shkreli made headlines when he acquired rights to a medication used to treat HIV - and promptly raised the price by several thousand percent. Now, drug maker Mylan is under fire for what some are saying is an even bigger threat to patient health - an increase of the price of the EpiPen two-pak to more than $600.
The lifesaving drug, which cost pharmacies less than $100 to buy in 2007, is used by many allergy patients with anaphylaxis to counter severe reactions to bee stings, nut allergies, and other allergens. Those who are prescribed the EpiPen are advised to carry two at all times and often these patients keep an EpiPen at the office, in the car, in their purse, and anywhere they may have a life-threatening emergency. Also, these devices must be replaced every year. Now, with the drastic increase in price, it will be far more difficult for patients to keep this drug on hand.
"I can't think of a worse situation for a parent to know that there's a medication that could save your kid and not being able to afford it," said Erin Fox, PharmD, of the University of Utah's Drug Information Service. In December, Fox testified for Congress against a pharmaceutical company in a similar case of alleged price gouging.
Price hikes may also influence a patient's decision to continue to purchase their medications at all. According to a 2013 study, 37 percent of U.S. adults "went without recommended care, did not see a doctor when they were sick, or failed to fill prescriptions because of costs." Considering the EpiPen is a medication that is not used every day but rather as a "just-in-case," Fox fears that patients will be likely to forgo purchasing it which could put them at grave risk. "People are going to have to make hard decisions. People could die," she said.
Mylan is responding to the backlash against the price hike by saying they will create a generic version of the EpiPen at a savings of 50 percent. However, some say 300 dollars is still too high of a price. They are also skeptical of Mylan's offering of savings cards they claim could save as much as half the new price for commercially insured patients. Critics say that will simply redirect the cost of the EpiPen to insurers, who will pass it on to consumers by raising premiums.
"Cost savings cards only work if you have really good commercial insurance. It's marketing, basically. It's getting an expensive drug into people's hands so they keep buying it. And it only works for some people," says Fox. Those who are excluded from the benefits of the savings cards are those with government insurance like Medicare and patients with high deductibles.
As allergy patients hold out for other companies to develop equivalents to the EpiPen or for the shelf life of the medication to be extended, Fox believes one of the best things we can do is be active about our outrage. "The media stories are great," she said. "It's public shaming." The stories, which may influence Mylan to reduce the price, are likely to keep coming due to the vast amount of people who rely on the EpiPen to survive.