EpiPen Epidemic

Lydia Marcus- Staff Writer

So…what is an EpiPen and how does it work?

Nasal allergies may be obnoxious, but they’re seldom fatal.

Food and medicine allergies, on the other hand, are known to trigger anaphylaxis, an allergic reaction that causes a person to go into shock. When in shock, a person’s blood pressure drops suddenly and the airways contract, making breathing very difficult.

As you might imagine, breathing and blood flow are important bodily functions. Being in shock can cause a person to lose consciousness or, in extreme cases, die.

Epinephrine, otherwise known as Adrenaline, is often used to treat anaphylaxis because it helps a person recover from shock by lowering blood pressure and relaxing the airways. Epinephrine is commonly administered via epinephrine auto injectors, more commonly known by the brand name EpiPen, a syringe that can be used to inject a pre-set amount of epinephrine into the person suffering from anaphylaxis. The “Epi” in EpiPen stands for Epinephrine.

Why is the news suddenly full of people upset about EpiPens? The EpiPen is somewhat unique—it has a monopoly on the market. Many of its competitors have failed, and Mylan, the pharmaceutical company that currently owns the rights to EpiPens, lobbied to pass the “EpiPen Law” in 2013. This law encouraged schools to stock epinephrine auto injectors and to mandate that school personnel are trained to use them. Mylan initiated a program called EpiPen4School, providing schools nationwide with more than 700,000 free EpiPens. As a result, EpiPens have steadily become the most familiar and, consequently, the most trusted brand of epinephrine auto injectors.

Because it has a monopoly on the epinephrine auto injector market, Mylan’s decision to raise the price of EpiPens continuously since 2009 impacts a lot of people with serious allergies. In 2009, two EpiPens cost about $100 wholesale; in 2016, two EpiPens cost more than $600. Obviously, this has significant ethical implications, and Mylan has received criticism from various fronts, including Congress.

Is this scheme new? Mylan isn’t the first pharmaceutical company that has sold its medicines at inflated prices. In 2015, it was revealed that Turing Pharmaceuticals had increased the price of Daraprim, a drug commonly used to treat and prevent malaria, by 5,000 percent; customers pay $750 per pill, or about $75,000 per month. Rather than lowering the price to something more reasonable, Turing provided programs that helped patients obtain the drug and forced insurance companies to pick up the slack.

The CEO of Turing, the suddenly infamous and widely loathed Martin Shkreli, justified the price increase, explaining that very few people actually use the drug, and the extra profit would be used to develop better treatments.

Both Mylan and Turing followed a similar pattern, one that has been used by a number of pharmaceutical companies in recent years: buy the rights to an old, infrequently used drug and remarket it as a speciality drug, raising the price accordingly. Apparently few people are impacted by the price increase, and pharmaceutical companies claim that the profit made will be used to benefit the people.

What should we do about it? It depends. Do you think it is ethical for pharmaceutical companies to charge more money for “speciality drugs” if they claim they’ll use the extra money to develop better drugs? Is it the role of the government to prevent companies from having monopolies on a market? Should people with allergies or parents whose children have allergies “vote with their wallet” by purchasing the epinephrine auto injectors sold by smaller companies, such as Adrenaclick, which costs about one-quarter of the price of EpiPen? Should insurance companies and/or taxpayers be expected to foot the bill for expensive medications? Should schools continue to buy the Mylan brand of epinephrine auto injectors?

You’ve got the basics of the situation, now. What are you going to do?

***Information taken from Asthma and Allergy Foundation of America, Bloomberg, and The New York Times

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