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EpiPen: Price-Gouging of Essential Medicine

Judy Stone, MD

Disclosures

August 26, 2021

I'm seeing red.

This is my arm, one day after I was stung by a yellow jacket while weeding my garden. Those little guys really hurt!

Image courtesy of Judy Stone

I was lucky that was the extent of the reaction. We summer in Maine, a seemingly idyllic place when we purchased a home. The small town even had a critical-access hospital, impressively accessible by boat and air as well as by a windy road. Such things matter more as you grow older. Lincoln County had the oldest population by county in the oldest state.

Shortly thereafter, it was déjà vu as the more than 100-year-old St. Andrews Hospital was "merged" with another and closed. This seemed needless and a matter of greed, as had the takeover and loss of Memorial Hospital in my Maryland community. I spoke out about both hospital losses and wrote a warning for other rural hospitals in a series in Scientific American.

But I digress. The upshot is that now you have to drive off the peninsula on a serpentine and often dangerous road to get any medical care after 8 PM, and there is only urgent care available otherwise.

I was grateful that I only had the one sting and worried about what might happen the next time.

So, I called my physician and asked for a prescription for an EpiPen to have on hand. When I went to pick it up at the pharmacy, I was charged $341 — with Medicare and supplemental pharmacy coverage. Such a bargain, "discounted" from the list price of $650-$700 without insurance. The generic costs $400.

In 2018, there were more than 2 million prescriptions for EpiPens.

Mylan was the sole manufacturer of EpiPens until a few years ago. During that time, it boosted the price about 600%. I wrote about the price-gouging under Heather Bresch, the company's CEO and Joe Manchin's daughter, here and won't go into the sordid details.

Last year, Mylan merged with Upjohn (long part of Pfizer) and was renamed Viatris. Bresch left that marriage with $30.8 million. The large generics pharmaceutical manufacturer and employer of 1500 people in Morgantown, West Virginia, closed its plant on July 31 and plans to outsource all of its production to India. Medications produced there include levothyroxine, doxycycline, and HIV drugs.

Now Manchin, who was said to be "ghosting" the workers, is concerned about the outsourcing from his state and is appealing to the Cybersecurity and Infrastructure Security Agency (CISA) to classify the plant as an "essential element of the national supply chain" and save it from closure. I don't understand the game being played.

Yes, I am still seeing red, but now for many more reasons. 

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About Dr Judy Stone
Judy Stone, MD, is an infectious disease specialist and author of Resilience: One Family's Story of Hope and Triumph over Evil and Conducting Clinical Research: A Practical Guide.

She survived 25 years in solo practice in rural Cumberland, Maryland, and now works part-time. She especially loves writing about ethical issues and advocating for social justice. Follow her at drjudystone.com or on Twitter @drjudystone.

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