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Anyone following the Epi pen drama?


lexi
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I'm not caught up with the latest news but I've been trying to keep up.

It sounds like a lot of corruption.

The latest article said the company might have violated anti-trust laws.

 

And the company has said it's going to offer more coupons. (Not lower prices as they've been asked to do).

 

So, thoughts? Opinions?

 

I'll try to get to my computer and link some articles if I can this afternoon.

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I am normally on the side of drug companies. I know how expensive it is to bring a drug to market. HOWEVER, in this case, it is not the cost of bringing a drug to market that was dictating the price. That to me is very wrong. What makes me even more upset on a human level is that these extra prices were not going back into the pipeline, but into the pockets of someone who did nothing but raise the price (the CEO). Research in pharma is a FRACTION of what it used to be in this country and she had the gall to do this. I don't mind paying more for a drug now that I need, to get one I will save my life in the future. 

 

The free market side of me says, let her do what she wants. The allergy side of me says this stinks. This drug should be as ubiquitous as antibiotics were 15 years ago (thankfully they are not still like that), so there is profit to be made there if they take the Walmart model to the drug (sell 1,000,000,000 units at a small margin, vs selling 10,000 units at a large margin). Allergies are on the rise and I can honestly see the day when you can't have a baby in a hospital without getting a script for an epi-pen. Allergies are that common. 

 

I hope something is done and they are investigated. They are giving all of pharma a black eye, and they don't need that right now.

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The thing is, this is the system we have chosen. The rest of the world, be it developed, undeveloped, the government negotiates a rate and does not let its citizens become prey to companies that have to report quarterly profits to shareholders. That is a profit making enterprise, and they are doing their job. The congress people who are crying foul only because this is in the news, are not. But we want unfettered "liberty" and limited government, well,'let's all feel so free paying 600 for epipens. Cheaper to fly to Mexico.

And I am so glad epipen is getting press. But what about people who have rare, chronic diseases, whose plight would never make the press? It's really sickening. In talking to my local, rural pharmacist, he states most people don't fill their prescriptions.

Edited by madteaparty
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I am normally on the side of drug companies. I know how expensive it is to bring a drug to market. HOWEVER, in this case, it is not the cost of bringing a drug to market that was dictating the price. That to me is very wrong. What makes me even more upset on a human level is that these extra prices were not going back into the pipeline, but into the pockets of someone who did nothing but raise the price (the CEO). Research in pharma is a FRACTION of what it used to be in this country and she had the gall to do this. I don't mind paying more for a drug now that I need, to get one I will save my life in the future. 

 

The free market side of me says, let her do what she wants. The allergy side of me says this stinks. This drug should be as ubiquitous as antibiotics were 15 years ago (thankfully they are not still like that), so there is profit to be made there if they take the Walmart model to the drug (sell 1,000,000,000 units at a small margin, vs selling 10,000 units at a large margin). Allergies are on the rise and I can honestly see the day when you can't have a baby in a hospital without getting a script for an epi-pen. Allergies are that common. 

 

I hope something is done and they are investigated. They are giving all of pharma a black eye, and they don't need that right now.

 

I am rarely on the side of Big Pharma, and I agree with you completely.

This is life-threatening stuff and should be free or very low cost.  We certainly pay the pharmaceutical companies billions in profit.  This is just wrong on every level. 

 

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This is the heart of the matter.  It's the heart of why ALL heathcare costs are so high.  Because of insurance.  And that's exactly the problem.  The thought process of "the insurance will pay for it" is not just in the drug companies minds...it's in the minds of the consumers too.  Most people with insurance don't think to shop around at different pharmacies because a) the insurance will pay for it and b) the copay is the same, because the insurance pays for the rest.  So for lots of folks, they actually don't have a clue what the price of the med actually is. 

 

I was the same way, until I went through fertility treatments.  I took my huge script list to the CVS I normally went to.  They priced it out at FOUR THOUSAND DOLLARS.  After insurance.  I freaked out, we did NOT have $4k.  The fertility office directed me to a compounding pharmacy in the area that didn't take any insurance.  They could fulfill my list for $400.  BUT, even better, I found a Kroger that matched the compounding pharmacy's prices, AND took insurance.  It ended up costing me only $25.  Now, sure I had insurance.  But that was the first time it occured to me that different pharmacies might actually price drugs different.  For folks who have always had insurance, never needed a drug that insurance doesn't cover....they just don't realize it.  And drug companies no that.

 

I am very much a supporter of the free market.  The problem is that with insurance companies, the prescription drug market isn't really free. 

 

That is appalling greed.  $4000, and someone else can sell it to you for $400 and still make a profit? 

Glad you ended up paying $25.

"Vengeance is mine, sayeth the Lord.  I shall repay."  (Or for the non-Christians, what goes around, comes around). 

 

Edited by TranquilMind
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The problem actually is government. If government didn't make and enforce patent laws then other companies could just step in and start making the drug. I have not seen convincing evidence that all the extra money paid for drugs goes back into research.

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The thing is....that was $4k, AFTER the insurance we had.  That was...essentially...what the copays would be, or whatever they called the uncovered portion.  There are insurance policies that have a lot more coverage for fertility treatments and meds.  And for people with those policies....they wouldn't really have a clue that the meds cost that much.  And not knowing what the actual price of the med is really hinders the free market proces. 

 

Is the drug company greedy for pricing the med so high?  Sure, you could say that.  But, the biggest reason they can price it so high is because SOMEONE will pay it.  In most cases...that someone is the insurance company.  Because those who need fertility treatments to get pregnant who have no or average fertility coverage likely CAN'T pay it....so they don't.  They "choose" not to have kids instead.

 

I am glad this epi pen situation is getting press.  But I think the press is misdirected.  While I think the drug companies are part of the problem....I think the insurance companies are the REAL problem and I don't think that will get enough press.  And with the ACA, we just gave them more power instead of restricting it.  (which, delving into conspiracy theory territory...could be why insurance companies aren't going to get enough press in this.)

 

We also need to get away from this idea that since the "insurance company is paying", we have no obligations.  The insurance companies are using OUR money, and profiting greatly.  We all should seek out the lowest cost options, wherever possible.   And insurance needs to be eliminated, but that's another issue.   The ACA has been a disaster for all except for a few people who couldn't get insurance at all. Everyone else is paying unbelievably high rates, especially young people who are bothering instead of being fined for being unable to afford these extortion rates. 

 

Usually press means the company makes a few false apologies and it goes away and they keep charging extortion rates. 

 

Edited by TranquilMind
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The thing is, this is the system we have chosen. The rest of the world, be it developed, undeveloped, the government negotiates a rate and does not let its citizens become prey to companies that have to report quarterly profits to shareholders. That is a profit making enterprise, and they are doing their job. The congress people who are crying foul only because this is in the news, are not. But we want unfettered "liberty" and limited government, well,'let's all feel so free paying 600 for epipens. Cheaper to fly to Mexico.

And I am so glad epipen is getting press. But what about people who have rare, chronic diseases, whose plight would never make the press? It's really sickening. In talking to my local, rural pharmacist, he states most people don't fill their prescriptions.

 

I know.  I wonder frequently how dumb ARE Americans?  There is so much evidence. 

 

Limited government would allow anyone to make the drug. 

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I am glad it is getting press. I just read today that they are offering greater coupons, which isn't quite the right direction but is a start. At least that should make it more affordable for families with high deductibles.

 

If a drug truly costs that much money to produce, okay, fine. That's lousy, but it is what it is. But this drug is cheap, and raising the price because of the delivery system, just because you can, is wrong. Especially when it leaves children without lifesaving medication. I'm glad to see a lot of talk about it.

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The problem actually is government. If government didn't make and enforce patent laws then other companies could just step in and start making the drug. I have not seen convincing evidence that all the extra money paid for drugs goes back into research.

 

Playing devil's advocate here, but if you don't want people and companies to profit* from their creations, what incentive is there for them to invest in doing it in the first place?

 

 

*not saying current profit levels are reasonable

 

ETA: If you're going to do away with patent law, that's not just going to affect medications.

Edited by Reluctant Homeschooler
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How many here actually understand the drug pipeline?

 

This is my understanding of it from my husband. He used to be in research but was one of the thousands that have been let go due to "saving cost". This is very simplistic terms of drug discovery but should give you an idea. 

 

Step 1 - A biologist figure out the protein target for a disease (This is normally at least a team of people)

Step 2 (optional) - a computational chemist goes through vast known compounds to look for something that will match it. If that doesn't work, they design a compound to match it, using various methods. This could also be a team of people

Step 3 - It is either designed by or a chemist makes the designed compound. Another team here!

Next steps goes through toxicologists, animal research, and various other people to determine if it is even safe to try on humans. Many drugs fail in this step.

Step 6 (or whatever) - A patent is filled in the US. This has a 20 year expiration date from the day it is filed. 

Step 7 - Phase 1 clinical trials - this is a small clinical trial to see if what they are seeing in the lab translates to people. It is way more then an educated guess, but it has risks.

Step 8 - Phase 2 clinical trials - If I remember right this is a large scale trial. 

Step 9 - This is where the FDA approves the drug, or it is sent back to do more phase 2 trials or to an even bigger phase 3 trial. Think of this as a bill stuck in committee (I'm just a bill, yeah I am only a bill, and I am sitting here on capital hill...). Sometimes they go through fast, most of the time they are stuck.

Step 10 - It looks like a drug is going to be approved by the FDA. So the pharma company ramps up and gets all the marketing, training, and other stuff made. The DAY a drug is approved, drugs are ready to be prescribed. The reason for this is by this point sometimes 12 years or more have past since step 6. That means they have 8 years to recover the cost of bringing it to market before it will go off patent and a generic manufacture from Timbuktu can sell it for pennies. 

 

This is overly simplistic, but you get the idea. Clinical trials are expensive. VERY expensive. Many drugs don't get past them. FDA requires this that and the other thing. It is mostly all good. I like drugs that don't kill people and make them better, but because that patent time limit, it makes it so SOME drugs are very expensive. 

 

I had a drug that was used in my chemo that was probably around $10K a dose. I had 6 doses. It was around (approved by the FDA) for less then 5 years when I got it. It was a nasty drug, they had so many people allergic to it, that I was told I had to take an antihistamine just to get it. Made with rat pee (I kid you not!). I have no problem with that drug. It saved my life and it likely had a very lengthly process to get approved. 

 

This Epi-pen controversy is not because Epi-pens are just expensive because of how long it took to bring to market, but because of greed. I remember last year when I was told my youngest needed an Epi-pen. I figured that there must be a generic as they have been around for a long time. The doctor asked me which one I wanted and I told her "the simplest! I know how I am and if I watch my child turn blue again I may not be able to remember my name, let alone count to ten!!!" So I got the AuviQ and I was shocked when I found out how much it was. I had a discount coupon (thankfully! We had awful insurance at the time). So I figured I would have to save my pennies to get him another one this year. Well then when it was recalled and I was prescribed one (happened nearly at the same office visit), I was shocked by how much they cost. I know Epi-pens have been around for a long time. Again I had a coupon though and I didn't have to pay for it. 

 

To me there is a huge difference between the $10,000 chemo drug I took, and the Epi-pen that costs $300+. The chemo drug saved my life just like an Epi-pen might one day, but the chemo drug was likely paying for how much it took to bring to market. The Epi-pen was not paying for how much it took to bring to market, it was paying for someone to get rich. HUGE difference in my mind.

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Yeah, the Epi-pen thing is a travesty. Companies should be able to recoup the costs of developing and testing a drug. They should be able to make a decent profit and protect their interest in their product for a certain amount of time. But it seems like there's a whole lotta ground between that and what's happening with many medications. If there's a better system, it's worth looking at. But if you somehow make drug development non-profit or put the government in charge, I wonder how much innovation and new meds would actually come to market. There has to be a way to find the middle ground so people can get what they need without going broke.

 

ETA: Finished thought.

Edited by Reluctant Homeschooler
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The costs starting going up recently, but it's the cost of the autoinjector, not the drug. Epinephrine is still dirt cheap but the delivery device is the arm and leg. There are other brands than Mylan who make epinephrine autoinjectors but I usually have to call and have them order them direct, they're not kept in stock.

 

It's complex and the group healthcare plans are the biggest issue, because hey can negotiate prices differently than individual consumers. I've been wanting to see that reformed since I understood the way medical insurance actually worked but so far all the efforts have been to worsen the problem, not improve it.

 

As someone who needs epinephrine it drives me nuts but the solutions are much more complex when you get into ownership of patents and price fixing/demand balance.

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How many here actually understand the drug pipeline?

 

This is my understanding of it from my husband. He used to be in research but was one of the thousands that have been let go due to "saving cost". This is very simplistic terms of drug discovery but should give you an idea. 

 

Step 1 - A biologist figure out the protein target for a disease (This is normally at least a team of people)

Step 2 (optional) - a computational chemist goes through vast known compounds to look for something that will match it. If that doesn't work, they design a compound to match it, using various methods. This could also be a team of people

Step 3 - It is either designed by or a chemist makes the designed compound. Another team here!

Next steps goes through toxicologists, animal research, and various other people to determine if it is even safe to try on humans. Many drugs fail in this step.

Step 6 (or whatever) - A patent is filled in the US. This has a 20 year expiration date from the day it is filed. 

Step 7 - Phase 1 clinical trials - this is a small clinical trial to see if what they are seeing in the lab translates to people. It is way more then an educated guess, but it has risks.

Step 8 - Phase 2 clinical trials - If I remember right this is a large scale trial. 

Step 9 - This is where the FDA approves the drug, or it is sent back to do more phase 2 trials or to an even bigger phase 3 trial. Think of this as a bill stuck in committee (I'm just a bill, yeah I am only a bill, and I am sitting here on capital hill...). Sometimes they go through fast, most of the time they are stuck.

Step 10 - It looks like a drug is going to be approved by the FDA. So the pharma company ramps up and gets all the marketing, training, and other stuff made. The DAY a drug is approved, drugs are ready to be prescribed. The reason for this is by this point sometimes 12 years or more have past since step 6. That means they have 8 years to recover the cost of bringing it to market before it will go off patent and a generic manufacture from Timbuktu can sell it for pennies. 

 

This is overly simplistic, but you get the idea. Clinical trials are expensive. VERY expensive. Many drugs don't get past them. FDA requires this that and the other thing. It is mostly all good. I like drugs that don't kill people and make them better, but because that patent time limit, it makes it so SOME drugs are very expensive. 

 

I had a drug that was used in my chemo that was probably around $10K a dose. I had 6 doses. It was around (approved by the FDA) for less then 5 years when I got it. It was a nasty drug, they had so many people allergic to it, that I was told I had to take an antihistamine just to get it. Made with rat pee (I kid you not!). I have no problem with that drug. It saved my life and it likely had a very lengthly process to get approved. 

 

This Epi-pen controversy is not because Epi-pens are just expensive because of how long it took to bring to market, but because of greed. I remember last year when I was told my youngest needed an Epi-pen. I figured that there must be a generic as they have been around for a long time. The doctor asked me which one I wanted and I told her "the simplest! I know how I am and if I watch my child turn blue again I may not be able to remember my name, let alone count to ten!!!" So I got the AuviQ and I was shocked when I found out how much it was. I had a discount coupon (thankfully! We had awful insurance at the time). So I figured I would have to save my pennies to get him another one this year. Well then when it was recalled and I was prescribed one (happened nearly at the same office visit), I was shocked by how much they cost. I know Epi-pens have been around for a long time. Again I had a coupon though and I didn't have to pay for it. 

 

To me there is a huge difference between the $10,000 chemo drug I took, and the Epi-pen that costs $300+. The chemo drug saved my life just like an Epi-pen might one day, but the chemo drug was likely paying for how much it took to bring to market. The Epi-pen was not paying for how much it took to bring to market, it was paying for someone to get rich. HUGE difference in my mind.

 

In reality, smaller pharmeceutical companies often do most of The first six-eight steps, then sell it to a big one with a marketing engine.

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The thing is, this is the system we have chosen. The rest of the world, be it developed, undeveloped, the government negotiates a rate and does not let its citizens become prey to companies that have to report quarterly profits to shareholders. That is a profit making enterprise, and they are doing their job. The congress people who are crying foul only because this is in the news, are not. But we want unfettered "liberty" and limited government, well,'let's all feel so free paying 600 for epipens. Cheaper to fly to Mexico.

And I am so glad epipen is getting press. But what about people who have rare, chronic diseases, whose plight would never make the press? It's really sickening. In talking to my local, rural pharmacist, he states most people don't fill their prescriptions.

Exactly. My medications would cost over $1000.00 per month for asthma and blood pressure meds if we did not have insurance or had a to meet a deductible for prescriptions. 

 

That is one of the reason why I could never understand folks who were against ACA law or universal single payer health care which is even better IMO. I heard at the time they were trying to pass the ACA law that folks who have no insurance can go to the emergency rooms. Well emergency rooms do not pay for medications and generic drugs are not always available or inexpensive. Plus emergency rooms only stabilize a person so they do not treat ongoing problems like cancer, diabetes, asthma, etc.

 

We need medicare for all or some version of it!

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In reality, smaller pharmeceutical companies often do most of The first six-eight steps, then sell it to a big one with a marketing engine.

A lot of the smaller companies can't afford the clinical trials. They are very expensive. So they do sell leads to the big pharma, but big pharma does pay for those leads and promising targets. So the pipeline is the same. 

 

I am not sure I have heard of one that was sold just because of the marketing. The marketing is a very small percentage of the budget, even if it is the one everyone sees. Think of an iceberg, what you can see is very little of the whole. 

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The costs starting going up recently, but it's the cost of the autoinjector, not the drug. Epinephrine is still dirt cheap but the delivery device is the arm and leg. There are other brands than Mylan who make epinephrine autoinjectors but I usually have to call and have them order them direct, they're not kept in stock.

 

It's complex and the group healthcare plans are the biggest issue, because hey can negotiate prices differently than individual consumers. I've been wanting to see that reformed since I understood the way medical insurance actually worked but so far all the efforts have been to worsen the problem, not improve it.

 

As someone who needs epinephrine it drives me nuts but the solutions are much more complex when you get into ownership of patents and price fixing/demand balance.

 

From what I understand, the EpiPen injector has been around for a long time  (Not sure how long since I only recently started to need one, but I've been aware if it for years.)  This company bought the rights to make this drug.  I don't know the time line specifics, but the competitors delivery device was taken off the market by the FDA, basically giving the EpiPen company a monopoly.  They took advantage of that and raised prices an astronomical amount.  The previous price increases had flown under the radar, even though there was no justification for them.  There was grumbling, but it didn't really capture the public's attention until they got really greedy and raised it by such an egregious amount.  Pairing that with the abominable compensation increase for the CEO (not for making a new, necessary product, but for buying up older medications that no longer had competition and jacking up prices) is where the outrage became part of the national conversation.

 

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I am glad it is getting press. I just read today that they are offering greater coupons, which isn't quite the right direction but is a start. At least that should make it more affordable for families with high deductibles.

 

If a drug truly costs that much money to produce, okay, fine. That's lousy, but it is what it is. But this drug is cheap, and raising the price because of the delivery system, just because you can, is wrong. Especially when it leaves children without lifesaving medication. I'm glad to see a lot of talk about it.

I am guessing and willing to bet that the epi pen delivery system costs a couple of dollars to make in China.

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An interesting aspect of this issue is that this drug company did not develop the product. It was developed through the DoD for military use and then allowed to be produced for public use.

 

This company is not in any way trying to recoup R&D costs. They are merely making a profit.

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I was told that government contributes a big chunk of R&D.

 

What about immorality of taking a drug that's cheap, changing a tiny thin that doesn't alter treatment outcomes, so you can go patent it again and rip people off. Elasticity of demand. If you need insulin, you will pay what you are told. You won't do that with cloths. If all the skirts in the world became a $1,000 per piece, I will simply wear pants. But if I need insulin, I have nowhere to turn.

 

If you haven't seen the segment on pharmaceuticals by John Oliver, please do.

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Anyone near Ontario, Canada, I just called and adult Epi-pens are $113.76 a piece at walmart no prescription needed.

 

WOAH, what?  Wonder what the legalities are of mailing those?  Wonder if customs would have kittens if I hop over the border and buy them?  Hmmm!!!

Edited by Catalytic
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Yes and no.

 

I get the problem. But ...

 

Welcome to the club that a whole lot of people are dealing with every single day for meds they need to survive another day.

 

Insulin for example has risen more than 200%. While someone with an allergy can at least try to avoid needing an epipen, my type 1 husband cannot do anything to avoid needing insulin every single day of his life.

 

There should be no outrage or surprise about epipens.

 

Because this is not an epipen problem.

 

It's an insane national pharmaceutical and medical care crisis problem.

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Don't get me started on those coupons. Works great if you 1. know about it, 2. have access to the internet to find it, 3. have access to a printer to print it off, 4. have the time to do all this before going to get the medication. 

 

I went to get a med filled and was shocked at the price. I said no, sorry. I went home, researched, found out about the coupon, printed it out, then went back. If I was a mom with limited transportation, no home internet, etc, how likely would that be to happen? Not to mention I wouldn't have time to go to the pharmacy twice, etc. 

 

It's another "poor tax" as far as I'm concerned. Those who need the discount the most are the least likely to get it. 

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I am guessing and willing to bet that the epi pen delivery system costs a couple of dollars to make in China.

Right. But they're still charging a fortune for it. I have a real problem with that. Make a reasonable profit -- fine. Nobody expects them to lose money or not have decent salaries. Or if they were suddenly having trouble sourcing one of the materials needed to make the delivery system -- okay, lousy, but stuff happens. Even raise your prices if your workers aren't making a living wage; we might not like it, but we could maybe stomach that. But the CEO got a huge raise on an already very good salary, and that's just wrong IMO for a non-luxury product like this. If they have some legit reason for jacking the prices up so much, I think they should disclose that publicly. At some point, there will be a reasonable alternative that is easy to use, administers the correct dosage easily, and is widely available, and at that point, people who don't have to have the Mylan brand specific product are very likely to jump to the alternative brand. People can have long memories. IMO, Mylan should be thinking about that. They will not be the only game on that level in town at some point.

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From what I understand, the EpiPen injector has been around for a long time (Not sure how long since I only recently started to need one, but I've been aware if it for years.) This company bought the rights to make this drug. I don't know the time line specifics, but the competitors delivery device was taken off the market by the FDA, basically giving the EpiPen company a monopoly. They took advantage of that and raised prices an astronomical amount. The previous price increases had flown under the radar, even though there was no justification for them. There was grumbling, but it didn't really capture the public's attention until they got really greedy and raised it by such an egregious amount. Pairing that with the abominable compensation increase for the CEO (not for making a new, necessary product, but for buying up older medications that no longer had competition and jacking up prices) is where the outrage became part of the national conversation.

 

Timeline doesn't work. The prices have been climbing for years before the Auvi-Q was removed and my pharmacists have pretty much confirmed it lines up more with insurance and Medicaid reimbursement rates than the cost of the drug. Again, epinephrine hasn't really changed prices. The price jack has been on Mylan's delivery device, which they hold the patent to. But other similar spring injector products for epinephrine are still cheaper, just harder to find. Their prices have climbed too but not at Mylan's rate.

 

No doubt this is a cash cow for them and they're raising prices for demand, but that's far from the whole picture.

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Yes and no.

 

I get the problem. But ...

 

Welcome to the club that a whole lot of people are dealing with every single day for meds they need to survive another day.

 

Insulin for example has risen more than 200%. While someone with an allergy can at least try to avoid needing an epipen, my type 1 husband cannot do anything to avoid needing insulin every single day of his life.

 

There should be no outrage or surprise about epipens.

 

Because this is not an epipen problem.

 

It's an insane national pharmaceutical and medical care crisis problem.

Agreed. It is across the board, though some of accounted for the bulk rise in spending and they're usually the drugs sold in highest unit volume for the market - insulin, heart medication, anti epileptics, etc.

 

Interestingly there are usually dosages and types still cheap in each one of these. I specifically request my doctors are vague on prescriptions so the pharmacist has the freedom to change brand and even division of the dosages (like three 15 mg pills instead of one 45 mg, if the smaller dosage is cheaper per dose) so they can help me find the best deal.

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WOAH, what? Wonder what the legalities are of mailing those? Wonder if customs would have kittens if I hop over the border and buy them? Hmmm!!!

Exact same vial of insulin here is $180-210 a vial.

 

We order it from Ontario or London and get a 3 MONTH supply including shipping for <$100.

 

No problems.

 

Other than American lobbiests trying to make it illegal under BS claims the drugs are subpar. They aren't. Exact same drug. Exact same manufacturer. Exact same distributor most times too. Only difference is those other countries don't allow unethical pricing.

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Exact same vial of insulin here is $180-210 a vial.

 

We order it from Ontario or London and get a 3 MONTH supply including shipping for <$100.

 

No problems.

 

Other than American lobbiests trying to make it illegal under BS claims the drugs are subpar. They aren't. Exact same drug. Exact same manufacturer. Exact same distributor most times too. Only difference is those other countries don't allow unethical pricing.

Sometimes, but not always. I think I've mentioned I'm a current state Board of Pharmacy member before, and we have been seeing a big issue with counterfeit mail order pharmacies and people being harmed by inadequate active ingredients or in some cases completely bogus formulations altogether.

 

All the states are working to address this while keeping access high for customers who cannot easily get to a local pharmacy or are trying to find a good price for legitimate medication. More details on that effort here:

http://www.nabp.net/programs/pharmacy/pharmacy-and-nabp

Edited by Arctic Mama
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I was told that government contributes a big chunk of R&D.

 

BIG fallacy is that the government does all the research. If that was the case, my husband would still be in research as government only seems to grow and not shrink. 

 

The reason why other drugs are costing more is 2 reasons.

 

1. People think things should stay the same price regardless of inflation. We have seen on this board people asking about why airfare cost more now. However statistically speaking, airfare has went down in price and we have had inflation. 

 

2. This is a big one. EVERY time any country puts price controls on drugs, those of us with no price control subsidize their prices. I don't think this is fair either but it is what it is.

 

Lets say this wasn't drugs we are talking about but cell phones. Lets say that France, UK, and Canada all said that they would not let Apple sell ANY iPhone for more then $10 (or any other cell phone for that matter too). After all it is a safety concern. So Apple would have a few choices. Stop making iPhones. Stop selling them in France, UK and Canada. Or make them and sell them in those countries but make the rest of us pay for those price controls. So instead of us paying what, $800 for the latest and greatest iPhone, we are now paying $1200 because we need to subsidize what those other countries should be paying for their iPhone. Same principle as with prescription drugs. 

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But that's counterfeit pharmacies. Most likely people buying indiscriminately off the net.

 

It's not even slightly difficult to make sure one uses a legit pharmacy.

You'd be surprised. Remember the information level of most consumers, as well as the spoof web portals and redirects. I can tell you that at least when it comes to inspection the more remote the pharmacy the more problems we have, from suitability of the facility for packaging (let alone manufacturing and compounding, both sterile and non-sterile preparations) to the quality of the staff. And it is regulated very differently in other countries, some better and worse.

 

The good news is that getting the domains standardized guarantees both a current list and a minimum quality standard via the inspection NABP already certifies, which are excellent and more rigorous than even those our state has adopted into regulation. Adding in reliable international pharmacies to the mix will only improve quality and access.

 

I'm well informed and I still have a personal horror story from an international pharmacy I was using. It happens more than you'd think, and they were legitimate (until they were sold, ugh).

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Anyone near Ontario, Canada, I just called and adult Epi-pens are $113.76 a piece at walmart no prescription needed.

Our closest Wal-Mart has them for adult $104, jr. $102.87 each. I will bet you're going to find similar prices across the country.

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Exact same vial of insulin here is $180-210 a vial.

 

We order it from Ontario or London and get a 3 MONTH supply including shipping for <$100.

 

No problems.

 

Other than American lobbiests trying to make it illegal under BS claims the drugs are subpar. They aren't. Exact same drug. Exact same manufacturer. Exact same distributor most times too. Only difference is those other countries don't allow unethical pricing.

I don't have any prescriptions currently but when I do I import them from a "third world country".

It's not just the amazing innovation that goes into the epipen. Look what's happened to Doxycylin, which is an antibiotic. Not exactly cutting edge technology.

Edited by madteaparty
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BIG fallacy is that the government does all the research. If that was the case, my husband would still be in research as government only seems to grow and not shrink. 

 

The reason why other drugs are costing more is 2 reasons.

 

1. People think things should stay the same price regardless of inflation. We have seen on this board people asking about why airfare cost more now. However statistically speaking, airfare has went down in price and we have had inflation. 

 

2. This is a big one. EVERY time any country puts price controls on drugs, those of us with no price control subsidize their prices. I don't think this is fair either but it is what it is.

 

Lets say this wasn't drugs we are talking about but cell phones. Lets say that France, UK, and Canada all said that they would not let Apple sell ANY iPhone for more then $10 (or any other cell phone for that matter too). After all it is a safety concern. So Apple would have a few choices. Stop making iPhones. Stop selling them in France, UK and Canada. Or make them and sell them in those countries but make the rest of us pay for those price controls. So instead of us paying what, $800 for the latest and greatest iPhone, we are now paying $1200 because we need to subsidize what those other countries should be paying for their iPhone. Same principle as with prescription drugs.

This is a faulty comparison. An egregious one.

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BIG fallacy is that the government does all the research. If that was the case, my husband would still be in research as government only seems to grow and not shrink.

 

The reason why other drugs are costing more is 2 reasons.

 

1. People think things should stay the same price regardless of inflation. We have seen on this board people asking about why airfare cost more now. However statistically speaking, airfare has went down in price and we have had inflation.

 

2. This is a big one. EVERY time any country puts price controls on drugs, those of us with no price control subsidize their prices. I don't think this is fair either but it is what it is.

 

Lets say this wasn't drugs we are talking about but cell phones. Lets say that France, UK, and Canada all said that they would not let Apple sell ANY iPhone for more then $10 (or any other cell phone for that matter too). After all it is a safety concern. So Apple would have a few choices. Stop making iPhones. Stop selling them in France, UK and Canada. Or make them and sell them in those countries but make the rest of us pay for those price controls. So instead of us paying what, $800 for the latest and greatest iPhone, we are now paying $1200 because we need to subsidize what those other countries should be paying for their iPhone. Same principle as with prescription drugs.

So taking this absurd scenario, if those government were such great negotiators and set a price, why can't our own do the same? no, it would choose to subsidize (and they are subsidized) a private company at the cost of the consumer. It's just who you pick to be the winner.
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Timeline doesn't work. The prices have been climbing for years before the Auvi-Q was removed and my pharmacists have pretty much confirmed it lines up more with insurance and Medicaid reimbursement rates than the cost of the drug. Again, epinephrine hasn't really changed prices. The price jack has been on Mylan's delivery device, which they hold the patent to. But other similar spring injector products for epinephrine are still cheaper, just harder to find. Their prices have climbed too but not at Mylan's rate.

 

No doubt this is a cash cow for them and they're raising prices for demand, but that's far from the whole picture.

The problem with the generic epi-pen is that most lay folks are unfamiliar with them. I know I would not want it to take even longer for my kid to get an epi-pen just because folks had to learn how to use it in an emergency which never works out well. I can testify as a nurse  that it is better to use a more common, universal design to make it easier for lay folks.

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Playing devil's advocate here, but if you don't want people and companies to profit* from their creations, what incentive is there for them to invest in doing it in the first place?

 

 

*not saying current profit levels are reasonable

 

ETA: If you're going to do away with patent law, that's not just going to affect medications.

 

 

Why do you assume I don't want people to profit from their creations? Of course, they should profit. 

 

Ideas can't be owned. They are not tangible material goods. There are industries that feed entirely off of copying ideas and changing them, for example the fashion industry. Somehow fashion designers still make money despite the fact that cheaper copies are sold to the masses. Really it is a leap of the imagination to assume that someone can't make any money off their idea because the government is not enforcing a strict monopoly on the idea for them. 

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Epipen Makers are crap in my book.   I have had one most of my life.  I started way back in the day when "epi pen" was two syringes and two bottles of epinephrine in a  little red tin case. And yea, teachers knew how to use it.  They can get a BA degree, they have the smarts to pull up a drug and inject into a body.  So everyone at the school knew how to use it.  This was mid 70's.   Somewhere around late 70's first of 80, I was given my very first Epi pen.   Taught how to use it and then taught the school to use it.  And it wasn't cheap. Around 50 which was a lot!  Sticker shock for my mom but necessary.  

 

One year in middle school, the school said they could only use EPi pen brand so don't bring any other.   Some bunk about laws had been changed and only Epi pens were now allowed.  In my teens, late 80s, I know 100% sure 1 and only 1 Epipen was round 60 dollars.  I paid 60 bucks for ONE every year until I was in my 30's (2009-2010) and going camping.  Could not buy 1 Epi but had to buy two.  MAD as hell and I mean mad as hell.  Fought, pitched a fit, and finally broke down and bought the two damn epipens for 130.00 that i didn't have so I could go camping and not die from a bee sting.   Why do you need to buy two?   If you want two, great. But why must you have two????  Especially since I had bought ONE for years and years.  NEVER BOUGHT ANOTHER ONE.  I kept those two epi pens long past expiration date and reduced my risk of bee stings as much as I could.  

 

Lucky enough, I have a few minutes from bee sting to throat closing and can make it to the hospital before blacking out.  As I refuse to buy another EPipen.  When they required you to buy two, that's when I knew  they were just out for profit.  Now....that's all this is. Pure greed due to so many little kids needing one and so many schools insisting on only Epipen brand.  You can still buy just a vial of Epi and buy a syringe. Not ideal but it is what we did before EpiPen came out.  Sure it is not an universal delivery system but if the country needs a universal delivery system, then it has to be affordable.  much like AEDs have come down in price as more people have put them into the first aid stations.   Drugs might change price but the technology of delivery should get cheaper over time.

 

Makers of Epi pen make me sick and have for a very long time.

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I don't buy that the issue is insurance covering it so the consumer doesn't see the price. Because in theory, the insurance company, fi they are footing the bill, should have been having a fit and negotiating the price. They had much more to lose, financially, as an entity paying for thousands of them, than any one consumer. 

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The problem with the generic epi-pen is that most lay folks are unfamiliar with them. I know I would not want it to take even longer for my kid to get an epi-pen just because folks had to learn how to use it in an emergency which never works out well. I can testify as a nurse that it is better to use a more common, universal design to make it easier for lay folks.

They actually all have instructions right on the cartridge in 1/2/3 fashion - they're almost the same. The basic is just to leave it in for ten seconds to be sure the medication is injected. That covers every single brand on the market except some drawn up in a syringe, and then you have families paying 1/4 the cost.

 

Really, the differences are minimal. Just like there is slight variation in inhalers so too with autoinjectors, but they're not enough to make a difference in an emergency. I wish I didn't know that from personal experience :lol:

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