On the EDge: Big Pharma is getting away with murder

Composite image: Lab by i3D_VR, epinephren injection by Roel Smart, both iStock/Getty Images Plus; St. George News

OPINION – There are a lot of stories out there right now talking about why and how Mylan, the company that manufactures the lifesaving EpiPen, can get away with jacking up its price from less than $100 in 2007 to more than $600 today.

Forget all that “compassion” and “concern” Mylan CEO Heather Bresch is jabbering about and consider, for a moment, that during the same time, her annual compensation went from $2.4 million to $18.9 million.

Ignore her crocodile tears when she says “Nobody is more frustrated than me” about the outrageous price hike.

And you can shelve the sleight-of-hand when she starts babbling about costs, insurance coverage changes and patent laws. The production cost has not grown proportionally to justify the hike, insurance rates and coverage have nothing to do with it – even though the claims amount to nothing more than a political backdoor slam at the Affordable Care Act – and the patent on EpiPens has expired, leaving the product open to competitive manufacturing.

No, we are dealing with a greedy corporate CEO here who also oversees the Generic Pharmaceutical Association – the generic pharmaceutical industry’s lobbying group.

EpiPen 2016 | Photo by Tokyogirl79 via Wikimedia's Creative Commons; St. George News
EpiPen 2016 | Photo by Tokyogirl79 via Wikimedia’s Creative Commons; St. George News

Bresch is also responsible for moving the company headquarters to The Netherlands in 2014, partially as a tax dodge and partially to employ a provision in Dutch law to avoid a company takeover.

And, a Master of Business Administration that was awarded her by West Virginia University was rescinded when it was later found that she did not complete enough classes for the degree and that political influence from her father, Sen. Joe Manchin, D-West Virginia, who was governor of the state when Bresch attended the school, and Milan Puskar, who was CEO of the drug company at the time and WVU’s biggest benefactor, may have helped her obtain the degree.

Insight into Bresch and Mylan helps us understand why some people will live and some people will die as a result of this price hike. It is really quite simple: Bresch jerked the price of EpiPens into the stratosphere because she can, and there is nobody willing to stop her because the company has bought and paid for the right to charge whatever it wants for this life-saving device.

Before the Blame Obama bunch weighs in, let’s try to sprinkle a little reason over this mess.

The problems lie far beyond the realm of the Oval Office.

They begin with Congress and end in the halls of the U.S. Food and Drug Administration.

For years, Big Pharma has had its indelicate way with the U.S. government, dropping mega-bucks at its feet via the most aggressive lobbying and campaign donation programs in history.

Nobody, not even the National Rifle Association, the insurance lobby, Big Oil or any of the other industries that feed our politicians comes near to what Big Pharma doles out each year in lobbying and campaign money.

So far this year, the pharmaceutical industry, according to OpenSecrets.org, a bipartisan group that tracks such things, has sprung for $129 million in lobbying, putting it on track to come in at about $240 million for the year, which would equal last year’s amount. That is $83 million more than the insurance industry spent last year and $110 million more than Big Oil handed out.

During the 2013-14 election season, the pharmaceutical industry handed out $15 million in campaign donations.

That buys a lot of influence.

So if you ever have to rush a friend or family member to the ER who is in danger for their life from anaphylaxis shock, wishing you had one of these EpiPens to help buy a little time, remember this: EpiPens are only lifesavers if you can afford them.

They were once carried by EMTs and other first-responders.

They were carried by many individuals whose lives could easily be endangered by allergic reactions.

This photo illustrates a young woman unable to breathe. According to the Mayo Clinic, one of the symptoms of anaphylaxis is constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing. Its webapge states: "Anaphylaxis symptoms usually occur within minutes of exposure to an allergen. Sometimes, however, anaphylaxis can occur a half-hour or longer after exposure. Anaphylaxis symptoms include: • Skin reactions, including hives along with itching, and flushed or pale skin (almost always present with anaphylaxis). • A feeling of warmth. • The sensation of a lump in your throat. • Constriction of airways (see above). • A weak and rapid pulse • Nausea, vomiting or diarrhea. • Dizziness or fainting." Mayo advises emergency medical help be sought immediately. "If the person having the attack carries an epinephrine autoinjector (such as an EpiPen or EpiPen Jr)," it advises, "give him or her a shot right away. Even if symptoms improve after an emergency epinephrine injection, a visit to the emergency department is still necessary to make sure symptoms don't return." | Photo by SLphotography/iStock/Getty Images Plus; St. George News
This photo illustrates a young woman struggling to breathe. According to the Mayo Clinic, one of the symptoms of anaphylaxis is constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing. Its webapge states: “Anaphylaxis symptoms usually occur within minutes of exposure to an allergen. Sometimes, however, anaphylaxis can occur a half-hour or longer after exposure. Anaphylaxis symptoms include:
• Skin reactions, including hives along with itching, and flushed or pale skin (almost always present with anaphylaxis).
• A feeling of warmth.
• The sensation of a lump in your throat.
• Constriction of airways (see above).
• A weak and rapid pulse
• Nausea, vomiting or diarrhea.
• Dizziness or fainting.”
Mayo advises emergency medical help be sought immediately.
“If the person having the attack carries an epinephrine autoinjector (such as an EpiPen or EpiPen Jr),” it advises, “give him or her a shot right away. Even if symptoms improve after an emergency epinephrine injection, a visit to the emergency department is still necessary to make sure symptoms don’t return.” | Photo by SLphotography/iStock/Getty Images Plus; St. George News

There was even a plan to stock them in schools across the nation to protect the lives of our children.

Now?

They have pretty well priced themselves out of the market.

Even first-responders are now carrying the drug used to combat anaphylaxis shock separately and using syringes to inject it instead of using the much easier to use EpiPens.

If you are geographically lucky, you can slip across the Canadian border and pick up a set of two for about $100. They go for the same price in most European nations.

Why so cheap there and so expensive here?

Because Big Pharma hasn’t figured out yet how to buy the souls of Canadian and European lawmakers.

The problem goes far beyond EpiPens, to be sure.

That’s why so many retirees and people living on a fixed income are purchasing their necessary medications across international borders, slipping into Canada or Mexico to buy the meds that sustain their lives.

The prices for these meds are fractional when compared with what prices in the United States are listed at and the meds, despite the rumors put out by government agencies, are just as effective. Just ask anybody who has spent any time abroad and relied on foreign pharmacies.

Why are pensioners going across the border to Toronto for their blood pressure pills?

Because they are the same, exact product sold in the U.S., but at as much as a 55 percent discount because of price caps set by the Canadian government.

There are some technicalities that can get you into a lot of trouble with the law if you bring prescription drugs across the border.

However, if those laws were uniformly enforced, the state governments of Wisconsin, Minnesota, Illinois and Vermont would be cuffed and stuffed for importing large quantities of medications distributed through their health insurance programs. So would many other city and county governments across the United States who are trying to give their employees a fair shake in their health benefits.

Big Pharma has used its monopoly to create these laws and charge whatever it wishes for decades.

It has weaseled its way into unfair practices regarding patents, offering extensions to drug manufacturers that are beyond reason. It has garnered a special place within the media, soaking it with advertising dollars to try to convince patients that they should demand certain drugs from their physicians. And, the physicians themselves have also been bought and sold by the drug merchants who ply them with free samples, lunches and other bribes, which is why some prescription drugs are pushed more than others. It is not always a case of which drug has greater efficacy, but more a matter of which drug is getting better PR and marketing at the moment.

Want to drive down medical costs?

Make it illegal for the pharmaceutical companies to advertise prescription drugs in the media. Seriously, who really knows best which drug suits a certain ailment?

Make it illegal for the pharmaceutical industry to lobby Congress and the FDA. Eliminate that money and you eliminate their influence.

Reduce the life of patents issued for all drugs. Usually the first product on the market is the one that remains at the head of the class.

Place caps on the cost of medications.

And, finally, heavily penalize any drug manufacturer who gouges the public with unrealistic price hikes, such as Mylan.

We all hear a lot of grumbling about how big government has become.

It’s really not a matter of how big government is, it is more a matter of how effective it is and who controls it.

Right now, it is controlled by the special interests – lobbyists and Corporate America – who have bought and sold our elected officials – and Big Pharma, which is getting away with murder.

Ed Kociela is an opinion columnist. The opinions stated in this article are his and not representative of St. George News.

Email: edkociela.mx@gmail.com

Twitter: @STGnews, @EdKociela

Copyright St. George News, SaintGeorgeUtah.com LLC, 2016, all rights reserved.

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9 Comments

  • Craig August 30, 2016 at 8:16 am

    This is just the tip of the iceberg. What is happening very methodically that is not making the news is becoming frightening.

    The British Medical Journal had an article titled, The Best Guidelines Money Can Buy.

    What do we do when “government” tells us how we must practice?

    https://www.holtorfmed.com/best-clinical-guidelines-money-can-buy-look-bias-guidelines-impact-thyroid-patients/

    Craig

  • .... August 30, 2016 at 8:32 am

    Lmao ! This is going to be good because the Amazing Bob is going to come in here and Blah Blah Blah about how the United States Government owns big pharma lock stock and Barrel. so according to The Amazing Bob that makes Obama the CE0 of big pharma …LOL !

  • BIG GUY August 30, 2016 at 8:41 am

    Let me start by agreeing that some drug companies exploit their positions as sole suppliers of a beneficial drug by raising prices egregiously. Mylan is the latest example.

    That stated, Ed decries the hundreds of millions of dollars spent by industry to lobby Congress and state legislatures. But he fails to acknowledge why they lobby. They do it because government has an excessive hand in almost all aspects of business life from the FDA, culpable in part in this case, all the way to licensing beauticians, barbers and florists. Read the front page of any newspaper’s business section and invariably a number of the lead stories will cover one aspect or another of government’s involvement in our economy.

    Government distorts markets, period. In a number of cases, reasonable people want these “distortions.” The FAA keeps airplanes from hitting each other, the FCC prevents multiple stations from interfering with each other’s broadcasts, etc. But Ed and progressives like him have found and continue to find free markets not their liking. There are “winners” and “losers.” Some are “left behind” and must be “helped” by government. As progressives lead government farther and farther into the economy, “protecting” us from businesses whose only possible motives can be greed and self service, they have distorted, twisted and over-regulated our economy to the point that we no longer grow fast enough to generate the taxes needed for their next progressive dream legislation.

    Do we need an FDA? Should it have the stranglehold it does on drug innovation? If we don’t allow patent protection for new drugs (which typically cost over $1 billion to develop), what will happen to drug innovation and life saving drugs that will never be discovered? Which companies will bother to try? Will they have to seek government approval in advance to do research? When will progressives decide that drug companies are no longer doing adequate research and propose that government labs take over new drug research? With politicians in charge of new drug research, which “disease du jour” will be funded based on its political popularity at the time? Will these government research labs be located in the states of influential politicians?

    This pattern, while hypothetical on my part, has been duplicated in far too many cases in the past and will be in the future until our economy is completely strangled and ceases to grow. Socialized countries around the globe show us where we are headed unless we get government to back away from over regulation and control. Socialist economies are directed and controlled by political elites. Is that what we want? How well have those elites served us to date?

    I argue that free markets allow those with the best ideas to serve the public while economies controlled by political elites serve those elites while flattening the rest of us into a mediocre existence.

    • eddantes56 August 30, 2016 at 7:01 pm

      You are correct on the free market. Well written comments.

      Price controls never work. See Nixon in the early 70s, Venezuela today….the examples are myriad. People just cannot understand the government is a poor administrator with no incentive to do a good job. (See USPS, Amtrak, et al.)

      Lasik surgery is a great example of the free market in action. Insurance doesn’t cover it; there was a definite market for it and the free market took a fledgling and helpful eye surgery, and initially offered it for $10K; once competition kicked in, the quality, price and everything about it improved and became more affordable. Today we have an excellent product with a low “fail” rate and the average Joe can afford it.

      We do not have a free market of medical care today. Ed does not understand that. Imagine if the insurance companies were out of this game or at a minimum had to compete in every state.

  • tcrider August 30, 2016 at 9:08 am

    This is nothing compared to what big pharma plans on doing when it comes to manipulating the cannabis market, they are already positioning themselves with
    lobbying and campaign donation programs in order to keep it from being a federal law, we could even see the recreation weed states lose their legal status and I will bet money it is happening right now. Big pharma is lobbying to keep cannabis not legal on a federal basis, granted they have a point by making weed safe, but in the end the price will probably be around 3000% of what the recreational stuff is now.
    In the end our capitalistic ways are hurting the people they are suppose to be benefiting, the only ones that benefit in the end are less than 1%.

  • DRT August 30, 2016 at 10:14 am

    Excellent article, Ed! It’s kind of scary that I seem to be agreeing with you more, as time goes by. One or the other of us has to be changing some points of view as we grow older. Shoot, maybe both of us are.
    In any case, this article points out a lot of things that the drug companies would just as soon we don’t know. Going over the border, (north or south,) for meds is not just restricted to seniors. Lots of folks do it. Considering that you can buy certain drugs out of country for less than your insurance deductible on the same meds, it is obvious why people do it.
    I’m wondering when some enterprising drug dealers will start importing legitimate drugs for their black markets. Kind of surprised if it isn’t already happening. Not being in knowing contact with drug dealers, I really don’t know.
    In the particular instance of the Epi-pen, if the patent has expired, it’s just a matter of time until it becomes available as a generic, and the price will go down. Heaven help folks who need it before that happens…

  • sagemoon August 30, 2016 at 11:00 am

    Great insight, Ed.

  • Brian August 30, 2016 at 3:20 pm

    Ed’s solution is more government control and regulation.

    But there is a very cheap, simple, and widely available solution to this exact problem: personal knowledge, personal responsibility and personal preparedness.

    Specifically, get the cheap epinephrine ($10), learn how to use it, and train those around you to use it:
    http://www.scarymommy.com/doctor-marcus-romanello-epi-pen-alternative/

    And because it’s cheap you can afford to buy more than one, so you have one at home, one in each car, one at work, etc. It fits in an Altoid’s tin, so it’s as convenient as an epipen.

    This solution strengthens the individual and weakens big pharma, and does so without expanding government. Imagine that. Conservative principles for the win!

  • debbie August 30, 2016 at 6:52 pm

    it is illegal to price gouge during an emergency.. it is a law in florida.. i venture to say it might even be a federal law. in florida if a hurricane comes and the water supply is tainted due to flooding.. the corner convenient store cannot sell its remaining stock of bottled water to the rich only for 800 dollars a bottle.. its considered price gouging during an emergency. a contractor cannot go door to door and charge 50,000 to put tar paper on peoples roofs after a hurricane.. i bet a good atty could argue.. this is “price gouging during an emergency”… not all meds are emergency.. but someone who is dying and needs an epi pen.. THATS an EMERGENCY. reposting on your facebook link on this..

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