Thoughts About the EpiPen Pricing Issue

Mylan is the latest manufacturer under fire for price hikes, this time involving the EpiPen.

After Auvi-Q was voluntarily pulled from the market for possible dosage errors, Mylan’s auto-injector found itself in a practical monopoly. The price of the a 2-pack of EpiPens has spiked to more than $600 in May 2016 from less than $100 in February 2007. In that time span, there have been 17 drug price increases.

These price increases shouldn’t simply be attributed to aggressive capitalism. When the US government offers marketing exclusivity, prices can legally skyrocket. Mylan’s behavior is quite reasonable in this situation based on the model of economic monopolies. The US health care system has long been complicated, in part because business interests are at stake when patient care decisions are being made.

Some proposed solutions involve federal regulations on pharmaceutical pricing, while others present regulation of R&D spending requirements. Of the 10 largest pharmaceutical companies, 9 currently spend more on marketing than R&D. Although this is hard to ignore, these solutions may not be built for long-term success because of the polarizing nature of federal spending requirements enforced on private and public businesses. While I’m far from an expert, a more natural competitive process that expedites substitute medication approvals seems like a strategy that could curb market monopolies.

Just as medication errors can’t be blamed on an individual pharmacist, the EpiPen pricing issue shouldn’t be blamed on one stakeholder. It’s easy to call Mylan the enemy, but it’s more powerful to comprehensively understand the problem.

Prescription medicines make up only 20% of all health care costs. The whole pricing system is a complex matrix of deals and bidding wars that trickle down to patients and providers, who are then left demanding more transparency. Manufacturers claim payers are forcing patients to account for higher portions of drug costs, while payers contend manufacturers don’t have justification to increase prices. I hope a more progressive and legitimate dialogue opens up between these 2 parties, considering the massive shares they hold in health care. Pharmacists can try our best to weave through blame games and continue advocating for patients first and foremost.