Friday, August 26, 2016

Epi-Pens Are Sticking It To Us

I usually try to keep things light around here. I generally write amusing stories about being a dad or the inanities of everyday life. But today I've got something that's stuck in my craw, and I feel the need to say something about it.

My oldest daughter ("Thing 1" to my regular readers) is deathly allergic to peanuts and tree nuts. Her doctor told us that as little as one-eighth of a peanut could cause a reaction that could kill her. So, we take it pretty seriously. We have no peanuts or cashews in our house. No Nutella. Not even any Reese's Peanut Butter Eggs at Easter. (You know I love my daughter very much if I'm willing to give up Reese's Peanut Butter Eggs!)

All we can really do is try our best to keep her away from nuts. (Easier said than done. One time my wife found the warning "may contain nuts" on a package of shredded cheddar cheese that I had purchased!) And, if by some chance she is exposed to nuts, we have to have the best available medical treatment close by so if she does have a reaction we will best be able to manage it until we can get her to a hospital.

And that's where Epi-Pens come into the story. An Epi-Pen is a medical device that injects a dose of medicine into a person. If my daughter were to have a reaction to peanuts or tree nuts, her airways would close up, making it difficult for her to breathe. She, or preferably someone else trained in their use, would use an Epi-Pen to inject a small dose of epinephrine into her to unblock her airways and allow her to breathe until she could get to a hospital and be treated by health care professionals.

Epi-Pens save lives! Epi-Pens are wonderful. Unfortunately, an Epi-Pen won't save a life if the person who needs it can't afford to buy it.

Epi-Pens are produced by a company known as Mylan Pharmaceutical. Mylan purchased the Epi-Pen brand in 2007, and has enjoyed a near monopoly on the automatic epinephrine injector industry ever since. ("Epi-Pen" is a brand name that dominates the industry, much like "Kleenex" dominates the facial tissue industry and "Jell-O" dominates the gelatinous food-like substance industry.)

Epi-Pens come in packages of two. (It is not possible to buy a single Epi-Pen.) Epi-Pens have an expiration date that is generally about a year from the time of purchase. At the start of every school year, we usually by three sets of Epi-Pens for our daughter, one for her to carry at all times, one for the school office to store in case of emergency, and one for us, as her parents, to have access to at all times.

Eli-Pens: So much money for something you hope to never use!

This year, when my wife went to purchase our first set of Epi-Pens, she was very perplexed on two fronts: the price and the expiration date. The price for one set of Epi-Pens was $531, and that was with a "coupon" for $100 off! (Yes, without the coupon the price would have been $631!)

When we first started buying Epi-Pens seven years ago, we could get a set for easily less than $50. (To be fair, I should point out that as those seven years have gone by, our insurance benefits and deductibles have changed many, many times, usually for the worse, so that has also had an effect on the amount we pay for Epi-Pens.)

Still, $531 is a lot of money, especially for something that you hope to never use. (Luckily, in the seven years since our daughter was diagnosed with her allergy, we've been able to avoid any reactions that would necessitate using an Epi-Pen. We've been very fortunate.)

The high cost has left us with the terrible choice of either paying out over $1,500 to have the number of Epi-Pens we feel comfortable with; or gamble with our daughter's life, buy fewer Epi-Pens, and hope we can continue to be fortunate and avoid allergic reactions.

We consider ourselves upper-middle white trash, so we can afford to pay for the Epi-Pens as long as we dip into our savings and limit spending on vacations, eating out, and going to the movies. Also, we had to cut back considerably on what we spend on the kids for back-to-school. No new backpacks, socks, or underwear. (Last year's stuff will just have to last longer.) But, for those families at the poverty level, they might be making the choice between having that life-saving medicine or putting food on the table.

Aside from the exorbitant price, the other problem with Epi-Pens is the quick expiration date. When my wife purchased our first set this year she was very disappointed to see that the Epi-Pens wouldn't even last the school year before they expired! This led to the following exchange between my wife and the pharmacist:

My wife: "These won't even last until the end of the school year!"
Pharmacist: "Well, maybe you should wait until closer to the start of school to buy them."
My wife: "School starts next week."
Pharmacist: "Oh."

(NOTE: I should point out that this pharmacist's snarky attitude is NOT the norm. Usually the pharmacists have been very kind and understanding. In fact, last year when faced with a similar expiration date problem, the pharmacist said, "You know, we're getting a shipment of Epi-Pens in tomorrow. Come back then and we'll see if we can get you one with a better expiration date.")

Mylan makes a lot of money off of Epi-Pens. Mylan has been able to continually mark up the price of their product because of a virtual monopoly on the market, and consumers who must buy their product or risk their lives or the lives of their children. Meanwhile, Heather Bresch, the CEO of Mylan, has seen her salary rise from just over $2 million dollars in 2007 to just under $19 million dollars in 2015! (Wow, with that kind of money she could even afford to buy a few dozen sets of Epi-Pens!)

But, this time they finally pushed the price a little too high. Over the past week or two, Mylan started receiving some serious pushback against their outrageous pricing. Facebook began to fill with posts from angry customers. News stories began to appear. Members of congress threatened to take action. Republicans and Democrats actually agreed on something!

And so yesterday, to diffuse some of the pressure, Mylan decided to make some concessions. In a press release by the company, Mylan says, "Company to cover up to $300 of out-of-pocket cost at pharmacy; reducing patient cost by 50% off Mylan list price."

Hey, that sounds great! ...Until you realize how much they're already jacking up the price. $300 off of $631 is still $331, and that's way too much for an Epi-Pen. It's like if McDonald's were to say, "We're asking $500 for a Big Mac, but we're going to give you a 50% discount so you'll be paying only $250!" Of course, one of the problems with that analogy is that the Epi-Pen contains needed, life-saving medicine, whereas a Big Mac is not going to save anyone's life. (At least not that I know of.)

And, as far as I can tell, this $300 off would only apply to people who have yet to purchase the Epi-Pens. It wouldn't do any good for us or the many like us who have already purchased our Epi-Pens for the school year.

Mylan probably thinks this grand $300 off ploy will appease the masses and take some of the negative spotlight off of themselves. I hope not. I hope people see it for the empty gesture that it is.

I think my mother-in-law (a very wise woman) put it best in her Facebook post when she said, "Mylan needs to lower the price for everyone and stop gimmicks that make it only seem like they're not still price gouging."

No comments:

Post a Comment