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Mylan to Lower EpiPen Cost — for Some
By Peggy O’Hare, Staff Writer, San Antonio Express News
A statewide professional group for Texas pharmacists expressed concern and disappointment Thursday
as Mylan defended its price hikes for its epinephrine medication
even as it lessened the burden for some patients.
The pharmaceutical giant has come under increasing scrutiny and
criticism in recent days for the higher prices it’s charging for its
EpiPen injections, which patients use to counter the life-threatening
effects of allergic reactions.
Mylan attempted to fend off unfavorable publicity Thursday by
announcing it will provide savings cards worth up to $300 to patients who pay full market price for the
EpiPen. Those cards will help cut those patients’ out-of-pocket costs in half, the drugmaker said.
Mylan also is expanding its financial assistance program to help patients earning incomes up to four
times the federal poverty level, such as a family of four earning $97,200 or less annually. Under the
broader eligibility requirements, a family who qualifies for financial help would pay nothing out of
pocket for their EpiPen.
Mylan announced those concessions in a statement to the media, but did not respond to requests for
comment.
However, CEO Heather Bresch told CNBC on Thursday that lowering the drug’s price was not an option.
“Had we reduced the list price, I couldn’t ensure that everyone who needs an EpiPen gets one,” she told
the network.
The concessions Mylan offered Thursday don’t address what pharmacies or health insurance companies
will pay for the EpiPen, said Erin C. Fuse Brown, an assistant professor of law in Atlanta who monitors
health care prices.
Even if an individual patient is somewhat shielded from the full market price, “someone else is paying
for it,” said Fuse Brown from her office at Georgia State University’s College of Law. “And then we all
pay for it. At the end of the day, when the insurance companies pay higher prices, then we all pay for it
in the form of higher premiums.”
Mylan charged only $100 for the EpiPen when it acquired the product in 2007. In the last couple of
years, the company has imposed two 15 percent price increases a year.
The full market price today is steep. At Stone Oak Pharmacy in San Antonio, owner and pharmacist
Ernesto Garza-Gongora said the EpiPen’s price tag is $730 before any discounts from health insurance,
Medicare, Medicaid or savings cards are applied.
At Spence’s Medical Center Pharmacy in Lake Jackson, a city about one hour south of Houston,
pharmacist Brigid Breazeale said the EpiPen sells for $773 before any discounts.
Adding to the headaches, the EpiPen is only sold in two-packs. Patients can’t purchase one injection at a
time.
The statewide professional group Texas Pharmacy Association condemned Mylan’s price hikes for the
EpiPen.
“As a pharmacist, I often hear the frustration from patients about the high cost of their medications, like
what has happened with Mylan’s EpiPen,” President Rene Garza said in a statement Thursday.
“Unfortunately, manufacturer-driven price increases such as this are becoming all too common and
unacceptable.”
Health insurance doesn’t always offer full protection to patients, particularly if their coverage has high
deductibles — meaning they must pay a specified amount for their health care and medications before
their benefits kick in.
“The biggest issue … for brand (name) prescriptions is that patients typically have to pay 90 to 95
percent” of a drug’s price if they haven’t yet satisfied their deductible, Garza-Gongora said Thursday at
Stone Oak Pharmacy.
“That’s where people will (decide) ‘I might have an anaphylactic reaction or an allergy, but I’m not going
to pay $700 for a prescription.’ And that’s basically understandable. Most people wouldn’t pay that.”
But some patients’ health insurance plans require them to fork over only a $50 co-pay for the
medication, Garza-Gongora said.
Patients aren’t the only ones feeling the burn of the EpiPen’s prices. So are pharmacists, who pay
wholesale costs to put the product on their shelves.
In the past year, Stone Oak Pharmacy has seen its wholesale price for a two-pack of EpiPen jump by 25
percent — from $440 in August 2015 to $581.22 today, Garza-Gongora said. The most dramatic price
hikes took effect after March, he said.
In Lake Jackson, Breazeale said her pharmacy pays $587 to obtain a two-pack of EpiPen. The pharmacy
has to stock the medication in case any customers have adverse reactions when they get vaccinated
there.
The wholesale price for a generic version made by Lineage Therapeutics isn’t much cheaper. The Lake
Jackson pharmacy pays a wholesale price of $421 just to obtain it, Breazeale said.
“It’s something that you need to prevent a severe allergic reaction, possibly death,” Breazeale said of
epinephrine. “So it’s better to have it on hand and keep it, versus going to the emergency room and
maybe not making it in time.
“Your alternative is have Benadryl on hand — take the liquid Benadryl. Especially people with shellfish
allergies,” she said. “If they’re eating something and they have an allergic reaction, that’s one thing.”