The cost of the EpiPen, a potentially lifesaving quick treatment for allergic reactions, has been rising steadily for nearly a decade — but it turned into a political scandal only this month, as Washington rushed to blast the manufacturer as a heartless price-gouger.
Mylan Pharmaceuticals bowed to pressure Thursday, saying it will offer rebates to cut the effective price in half for some customers and will expand its program for those without insurance so many families won’t have to pay anything for the EpiPen autoinjectors that can stave off anaphylactic shock.
But that failed to mollify lawmakers, who said the hike from about $100 in 2009 to more than $600 today is unfair and immoral, and who have threatened to come down with the full force of congressional oversight and legislation.
“The announcement today doesn’t appear to change the product price,” said Sen. Chuck Grassley, Iowa Republican and chairman of the Senate Judiciary Committee. “The price is what Medicare, Medicaid and insurance companies pay. It’s what patients who don’t get assistance cards pay.”
Mylan is the latest company to find itself in the crosshairs of Congress, as lawmakers are increasingly turning a critical eye toward the pricing decisions of major pharmaceuticals.
Analysts say Congress’ interest in the problem has developed over the past two or three years, as companies acquired drugs that were already decades-old and then raised their prices exponentially, hoping to maximize profits.
“You’re seeing these incredible price increases, and you’re seeing companies get away with it,” said Leigh Purvis, director of health services research at AARP Public Policy Institute. “The whole reason for these increases is there’s nothing in the system to stop them.”
Doctors began to critique high prices alongside consumers, she said, and the media paid closer attention to price increases across the board.
As lawmakers get an earful back home, they are increasingly making an example of outliers, as Congress struggles to find consensus on a patchwork of proposed fixes.
Martin Shkreli, pejoratively dubbed the “Pharma bro” for his fraternity-style approach to his social life, enraged members of the House Oversight and Government Reform Committee this year by refusing to say why he increased the price of a decades-old drug more than fiftyfold. He repeatedly invoked his Fifth Amendment right to silence in a February hearing and later mocked lawmakers.
Two months later, the departing CEO of Valeant Pharmaceuticals acknowledged to a Senate panel that his company was too “aggressive” in pursuing price hikes for products it acquired from other drug manufacturers, though his mea culpa did little to assuage lawmakers, who said he put Wall Street’s expectations over seriously ill patients.
Robert Laszewski, a health policy consultant in Alexandria, Virginia, said Mylan basically “walked right into” a tongue-lashing with its EpiPen price increases.
“Politicians love an outrageous player, because they can all gang up on it,” he said.
The U.S. spends more per capita on prescription drugs than any other country, yet lawmakers have struggled to find consensus on proposed fixes, such as expanding access to generic drugs, allowing customers to import drugs from Canada or giving the Medicare program more negotiating power over manufacturers.
Outrage over the EpiPen price coincided with the new school year, as parents made sure children with allergies were fully stocked before entering the classroom.
Sen. Susan M. Collins, Maine Republican, and Sen. Claire McCaskill, Missouri Democrat, said school districts and taxpayers could be affected by the price increases because many schools stock epinephrine auto-injectors.
Democratic presidential nominee Hillary Clinton called the price hike outrageous and “just the latest troubling example of a company taking advantage of its consumers.”
In response, Mylan said it will hand out $300 savings cards to customers with high out-of-pocket costs, effectively reducing the price by half for people who were paying the full list price. It also tweaked its patient assistance program so that a family of four making up to $97,200 would not have to pay out of pocket for the pen.
Mylan CEO Heather Bresch, the daughter of Sen. Joe Manchin III, West Virginia Democrat, blamed the problem on a health care system with increasing high-deductible plans that force consumers to pay the list price for EpiPen themselves in addition to the premiums.
She also said middlemen drive up costs, noting that there are “four or five hands that the product touches, and companies that it goes through, before it ever gets to that patient at the counter.”
“No one’s more frustrated than me,” she said.
But her own father has joined the ranks of those demanding answers.
“I am aware of the questions my colleagues and many parents are asking and frankly I share their concerns about the skyrocketing prices of prescription drugs,” Mr. Manchin said in a statement.
“Today I heard Mylan’s initial response, and I am sure Mylan will have a more comprehensive and formal response to those questions,” he said. “I look forward to reviewing their response in detail and working with my colleagues and all interested parties to lower the price of prescription drugs and to continue to improve our health care system.”
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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