This is why people think drug companies are jerks (insert enhancing descriptions if you like).
This is why people think drug companies are jerks (insert enhancing descriptions if you like).
Depending on where you look, there's maybe $1 worth of drug inside each epi-pen. Maybe. It is beyond my comprehension that the device itself is still under patent, since I'm still pretty sure this is something developed for the military for anti-chemical weapons drug self-admin on the battlefield back in the 70's or before. However, maybe you can tweak some small meaningless thing and re-up or get a new patent and that's how it's been extended. Whatever it is, there is no way on god's green earth that it costs hundreds of dollars for cheap plastic.
Lastly, this particular article makes it sound like it would be terrible if people had to use "DIY" syringes. Newsflash, until the 1980's, when the switchover to epi-pens became a thing, everyone used syringes. Either you had ampoules of adrenalin (epinephrine) and syringes like insulin syringes, or you had an Ana-kit, which was a little red plastic box (that was actually easier to carry around than the now gigantic epi-pen cases) with a little glass syringe in it that had two measured doses of the adrenalin/epinephrine. You had to turn the plunger each time you used it.
Epi-pens are so expensive that emergency response protocols in large metropolitan areas, like King County, where Seattle is, no longer use them but have switched (back) to syringe and drug vial kits they make up. Same drug, same treatment, ridiculously cheaper.
Epi-pens were pushed and became popular partly because nobody had to learn how to be unafraid of injections, and because they are measurably quicker. Although if the syringe is pre-loaded, like the old kits, not by much. Some people probably wouldn't be good at staying calm and drawing up their own injection in the right amount, but if we're subjecting people to up to $500 (yes, that is an actual and correct retail price on epi-pens) that they cannot afford and therefore have nothing, why aren't we simply writing for syringes and vials?
Well, for one thing, I asked a pharmacist and for reasons neither they nor I can understand, they aren't allowed to dispense ampoules/vials of adrenalin/epinephrine. ?!?!??!
Another reason, I'm sure, is a lurking fear of lawsuits. You didn't teach them how to self-administer properly, it's inherently unsafe to allow people to self-administer, they got sick and died because they measured it wrong, side-effects, etc.
Lastly, there are several generations of health care providers out there who don't know anything other than epi-pens. They wouldn't know what to write for, and they themselves would be uncomfortable prescribing it or having to dose it under pressure.
So they marketed the heck out of epi-pens, monopolized the market, and jacked the prices up. Oh, and apparently lobbied the FDA in ways that sound great on paper but not so much in real life. Speaking of which, where were the insurance companies in all of this? Either they weren't having to pay full price, or they weren't complaining. Considering how much they complain about everything else they don't want to pay for, that stretches credibility. Or, you know, they're hypocrites, too.
http://www.nbcnews.com/business/consumer/mylan-execs-gave-themselves-raises-they-hiked-epipen-prices-n636591
http://www.nbcnews.com/business/consumer/mylan-execs-gave-themselves-raises-they-hiked-epipen-prices-n636591
Depending on where you look, there's maybe $1 worth of drug inside each epi-pen. Maybe. It is beyond my comprehension that the device itself is still under patent, since I'm still pretty sure this is something developed for the military for anti-chemical weapons drug self-admin on the battlefield back in the 70's or before. However, maybe you can tweak some small meaningless thing and re-up or get a new patent and that's how it's been extended. Whatever it is, there is no way on god's green earth that it costs hundreds of dollars for cheap plastic.
Lastly, this particular article makes it sound like it would be terrible if people had to use "DIY" syringes. Newsflash, until the 1980's, when the switchover to epi-pens became a thing, everyone used syringes. Either you had ampoules of adrenalin (epinephrine) and syringes like insulin syringes, or you had an Ana-kit, which was a little red plastic box (that was actually easier to carry around than the now gigantic epi-pen cases) with a little glass syringe in it that had two measured doses of the adrenalin/epinephrine. You had to turn the plunger each time you used it.
Epi-pens are so expensive that emergency response protocols in large metropolitan areas, like King County, where Seattle is, no longer use them but have switched (back) to syringe and drug vial kits they make up. Same drug, same treatment, ridiculously cheaper.
Epi-pens were pushed and became popular partly because nobody had to learn how to be unafraid of injections, and because they are measurably quicker. Although if the syringe is pre-loaded, like the old kits, not by much. Some people probably wouldn't be good at staying calm and drawing up their own injection in the right amount, but if we're subjecting people to up to $500 (yes, that is an actual and correct retail price on epi-pens) that they cannot afford and therefore have nothing, why aren't we simply writing for syringes and vials?
Well, for one thing, I asked a pharmacist and for reasons neither they nor I can understand, they aren't allowed to dispense ampoules/vials of adrenalin/epinephrine. ?!?!??!
Another reason, I'm sure, is a lurking fear of lawsuits. You didn't teach them how to self-administer properly, it's inherently unsafe to allow people to self-administer, they got sick and died because they measured it wrong, side-effects, etc.
Lastly, there are several generations of health care providers out there who don't know anything other than epi-pens. They wouldn't know what to write for, and they themselves would be uncomfortable prescribing it or having to dose it under pressure.
So they marketed the heck out of epi-pens, monopolized the market, and jacked the prices up. Oh, and apparently lobbied the FDA in ways that sound great on paper but not so much in real life. Speaking of which, where were the insurance companies in all of this? Either they weren't having to pay full price, or they weren't complaining. Considering how much they complain about everything else they don't want to pay for, that stretches credibility. Or, you know, they're hypocrites, too.
http://www.nbcnews.com/business/consumer/mylan-execs-gave-themselves-raises-they-hiked-epipen-prices-n636591
http://www.nbcnews.com/business/consumer/mylan-execs-gave-themselves-raises-they-hiked-epipen-prices-n636591
I tried to find the patent expiration date on this earlier today, and failed. I saw several articles state unequivocally that it was still under protection, and got as far as Mylar buying the patent back in 2007. I saw one state unequivocally that it was not (Gizmodo) under protection any longer. None of them provided anything remotely resembling a source of this information.
ReplyDeleteI saw a number of references to very recent (last two years) denials by the FDA (or withdrawals from FDA consideration) from licensing. And there are generic equivalents on the market with slightly different mechanisms.
So if I were to spin a convincing line of maybe-bullshit, I would guess they (and the company they bought to get the patent before them) have been tweaking the mechanism enough to renew the patents and have been the recipients of an astonishing degree of good luck in having competitors fail, as well as in terms of convincing everyone that the generics shouldn't be used.
There originally weren't any competitors, other than the Ana-kit and things like it. People have been trying to enter the market to complete relatively recently, my guess is because Mylan is making ungodly amounts of money. However, they seem to have a conspiracy theory worthy grip on the hearts and minds of everyone and everything with the official epi-pen brand, including the FDA.
ReplyDeleteHowever, maybe you can tweak some small meaningless thing and re-up or get a new patent and that's how it's been extended. Whatever it is, there is no way on god's green earth that it costs hundreds of dollars for cheap plastic.
ReplyDeleteYes, yes you can.
John Novak Did you see a name of the patent or some keywords for it? I was thinking of going to try and pull down the US patent on it out of curiosity.
ReplyDelete