Monday, August 29, 2016

Next Year, Buy from Generic competitors to EpiPen.

Thanks for nothing. The company that upped the price on EpiPen's now wants to dominate the "generic" market with the same drug? I could be wrong but maybe just dropping the price would be easier than discount cards, insurance deals and a generic side product.
Click to enlarge
The drug maker's generic EpiPin will sell for $300, half the cost of its branded product. The move comes amid criticism from the public and lawmakers over big price hikes.
$300, what a break? It was just $100 back in 2009. Mylan of course wants to negotiate downward, while still raking in the higher prices paid by the poor and uninsured.

About a week ago, Mylan's CEO Heather Bresch said she was also frustrated by the price, despite ever really justifying the hike or proving the middleman fee structure changed that much (pictured below). The CNBC Squawk Box host Brian Sullivan did a great job of holding Bresch's feet to the fire:

The price of the EpiPen has soared 500% since generic drug company Mylan bought the treatment nine years ago. Yet Mylan’s controversial CEO Heather Bresch says she and her company aren’t solely to blame. 
Here's the chart (a little fuzzy) that supposedly passes the blame for the price increase onto the middlemen, and not poor Mylan:
"My frustration is there's a list price of $608," said Bresch, who said that price reflects a system where 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." ... intermediaries including wholesalers, retailers and pharmacy benefit managers add to the ultimate cost, and hence can increase the amount paid by patients. She noted that Mylan has costs that include "manufacturing the product, distributing the product, enhancing the product, investing."
 You mean like before when prices were lower? Seriously?

Bresch also blamed our broken health care system based on private insurance companies and high deductibles. And don't forget, high deductible insurance came right out of the Republican idea factory, as a way to make sure patients have "skin in the game" (like being sick or injured isn't enough skin in the game). 
She said that the health-care system is in crisis, causing the patient to pay for full retail prices at the drug counter and rising premiums on their health insurance.

"The patient is paying twice," Bresch said. "They're paying full retail price at the counter, and they're paying higher premiums on their insurance.
I thought this paragraph in The Atlantic pretty much summed up our totally screwed up health care system, which would get much worse under Republicans who want to give insurers and big pharma total control:
"Of course, one reason employers are moving to higher-deductible plans is because they’re reacting to rising health-insurance costs—which are climbing in part because companies like Mylan are hiking drug prices." - The Atlantic
Another reason for EpiPen's price increase? Let the Insurance companies pay, or so says "J. Michael Pearson, the former chief of Valeant Pharmaceuticals International, which has come to be viewed as an industry pariah after profiting for years on drastic price increases on old drugs:"

Drug maker Mylan also moved out of the US, in one of those corporate "inversions." Note: A competitor says they'll be back, after their own generic version was recently recalled:
Mylan acquired the EpiPen when it bought a group of medications from drug company Merck in 2007. At the time, the product only produced about $200 million in revenue. Today, according to Bloomberg, it makes about $1 billion per year for the formerly US-based company, now headquartered in the Netherlands after a corporate inversion last year.

The EpiPen is no longer covered by patent protection, but it still has no real competitors. Auvi-Q, the only thing that came close, was recalled for delivering faulty dosages almost a year ago. A competing drug company, Teva, didn’t win approval for its generic version of the EpiPen this year. Teva won’t try to win FDA approval again until at least 2017.
So before you blame the Affordable Care Act for insurer price hikes and cost shifting to high deductibles, you might want to direct your frustration at the pharmaceutical companies.

Here's Sen. Elizabeth Warren's explanation, which makes a whole lot of sense:
"These changes will help some customers who are struggling to afford EpiPens. Your discount programs, however, represent a well-defined industry tactic to keep costs high through a complex shell game," Warren wrote.

"When patients receive short-term co-pay assistance for expensive drugs, they may be insulated from price hikes, but insurance companies, the government, and employers still bear the burden of these excessive prices. In turn, those costs are eventually passed on to consumers in the form of higher premiums."
There's more:
Makers have raised prices on brand-name drugs by double-digit percentages since the start of the year, according to interviews with executives at Express Scripts and CVS Caremark, two major drug-benefit managers. “It used to be the drug companies only took one price increase a year,” said Dr. Steve Miller, chief medical officer at Express Scripts. “Now what they’re doing is taking multiple price increases multiple times a year.”

One of the cruelties of drug pricing is that the burden falls most heavily on those least able to pay it. Uninsured patients often must pay the list price of a drug, and an increasingly large share of insured customers are being asked to pay a percentage of the list price.

“It’s sort of embedded in the health care system that the price is never the price, unless you’re a cash-paying customer,” said Adam J. Fein, president of Pembroke Consulting, a management advisory and business research company. “And in that case, we soak the poor.”

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