do you have a severe allergy?

[Malcolm]

Have fun paying out the ass for your emergency plan B.

CBS News reports that the price of EpiPens has increased by more than 480 percent since 2009, two years after Mylan purchased the device from Merck. A two-pack used to cost pharmacies about $100. It's now $600, and they have a stated expiration of one year. But health insurance covers that, right? It depends on your plan. If you're one of the many people with a high-deductible plan, you could be stuck with the bill. Parents of children with severe allergies are told to have devices at home and school, too, which can add up fast. Two packs can set some people back $1,200.

Why the jack?

Mylan told CBS in a statement that EpiPen's price "has changed over time to better reflect important product features and the value the product provides," adding, "we've made a significant investment to support the device over the past years." That investment might be little more than marketing. Nielsen figures show that Mylan spent $35.2 million on EpiPen commercials in 2014, up from $4.8 million in 2011.

So ... why can't someone come in and make a generic version?

Epinephrine itself is very cheap; Mylan is essentially charging for the patented auto-injector, and they have a virtual monopoly on the market. There is a generic version, but the injector is different (another generic is in development) and a rival device was recalled in October.

Yep, you're paying mostly for the way they stab you. I'm betting because someone has abused the fuck out of the IP system and made it damn near impossible to design or make a feasible injection system without going through them.

[GORDON]

I've been wondering why there isn't a viagra clone, yet. It's been 20 years, hasn't it?

Not that I need it.

I just know the pills are expensive.

[TheCatt]

I've been wondering why there isn't a viagra clone, yet. It's been 20 years, hasn't it?

Not that I need it.

I just know the pills are expensive.

Pfizer, the manufacturer of erectile dysfunction med Viagra, just reached a settlement with generic manufacturer Teva that will allow Teva to start selling generic Viagra (sildenafil) in December 2017—that's more than two years earlier than the current patent expiration in April 2020.

Just in time for you, grandpa.

[GORDON]

I used to do a lot of IT stuff in pharmacies, so I overheard a lot of stuff I am not allowed to talk about because of HIPAA rules. But there have been some embarrassing and loud and hilarious discussions about viagra between old men and the young pharmacy tech girls.

[Leisher]

I have a daughter that's one of the lucky 20% to lose their peanut allergy. We used to have to buy epipens. $100 a pop and I have really good insurance.

The thing they don't mention in that article is the pharmacies try to give you the oldest epipens they have. So when you buy a new one for the year, you might be given one with only 6 months left before it expires. We caught it every time and demanded a fresher one.

Scumbags.

[Malcolm]

Feds getting into it.

So now there’s only the EpiPen and Adrenaclick, a generic version. The Adrenaclick is much cheaper. Consumer Reports says it found the device for $142 at Walmart and Sam’s Club with a coupon, as opposed to the current $600 to $700 price for EpiPens.

But many doctors are reluctant to recommend the generic version because the steps you have to take to inject the drug are different, and most people, including teachers and nurses, are trained on EpiPens. You wouldn’t want them fumbling around for directions in an emergency when seconds could matter.

Come the shit on. Is it that the design can't be honed without infringing on patent designs or are the training programs that fucking stupid?

[GORDON]

My kid MAY have a tree nut allergy, so we got a couple pens just in case..... 30 bucks on non-obamacare insurance.

The seasick patches were $70 for 10.

[Malcolm]

It keeps getting better.

While the mounting attacks may be enough to unnerve even the hardened chief executive, Bresch has a longer history than most of dealing with such issues and coming out (mostly) unscathed.

In fact, Fortune, in a tough profile, once described her career as being full of "ethically messy mishaps and public relations gaffes." At least two involve her own father, Sen. Joe Manchin III (D-W.Va.).
...
The most scandalous incident occurred in 2008 shortly after she was named the company's chief executive and involved the master's degree in business administration from West Virginia University that was listed on her resume. It turns out she never got it. An investigation by the school, prompted by a newspaper report, found that some administrators had added courses and grades to her transcript to make it look as if she had completed the required coursework.
...
In 2015, Bresch caused another firestorm when she merged Mylan with a company in the Netherlands. The transaction is known as a "tax inversion" and involves joining with a foreign entity to move a legal corporate headquarters abroad. Doing so provides a major advantage: trading U.S. corporate taxes, which at 39 percent are among the highest in the world, for a tax bill from a different country that is presumably less.
...
"EpiPen prices aren't the only thing to jump at Mylan," NBC News reported. According to Securities and Exchange Commission filings, Bresch's total compensation went from $2,453,456 to $18,931,068 from 2007 to 2015. That's a striking 671 percent increase. That period coincides with the period when Mylan acquired the rights to EpiPens and steadily hiked the average wholesale price from about $55 to $320.

Sounds legit.

[GORDON]

I get that items will sell for what peeps are willing to pay.... but when it comes to, basically, THE ANTIDOTE.... maybe there should be a higher morality than "Profit."

[TheCatt]

In fact, Fortune, in a tough profile, once described her career as being full of "ethically messy mishaps and public relations gaffes." At least two involve her own father, Sen. Joe Manchin III (D-W.Va.).
...
The most scandalous incident occurred in 2008 shortly after she was named the company's chief executive and involved the master's degree in business administration from West Virginia University that was listed on her resume. It turns out she never got it. An investigation by the school, prompted by a newspaper report, found that some administrators had added courses and grades to her transcript to make it look as if she had completed the required coursework.

How did that not get her fired? And her dad investigated?

[Vince]

I don't know, the pricing doesn't bother me for whatever reason. Or I guess it doesn't bother me more than a couple dozen other things going on in our society and culture today. Too far down on my list of things to give a shit about. Probably would feel different if I or a family member had an allergy.

My mother's neighbor is a grandmother that keeps hr grandson. My mom was telling me she felt sorry for him because he was super sheltered. He has a peanut allergy and his grandmother decided that he probably has an allergy to other nuts as well and won't let him eat any nuts at all. Seems kind of stupid since a peanut isn't a nut.

[Leisher]

I don't know, the pricing doesn't bother me for whatever reason. Or I guess it doesn't bother me more than a couple dozen other things going on in our society and culture today. Too far down on my list of things to give a shit about. Probably would feel different if I or a family member had an allergy.

That's a really uninformed and bad statement.

Someone with a severe allergy needs only be exposed mildly and it can result in death. People die from their peanut allergies all the time because of cross contamination or fucking dust. Imagine having a child with an allergy so severe that merely being in a room with a peanut product can trigger an attack. Now picture trying to take that child anywhere or go to a restaurant or have the kid in school where other parents will bitch and moan that they can't give their kids PB&Js because of your kid, etc.

On a side note, the parents who bitch about allergies I regard as subhuman. I honestly think they're everything wrong with the world and should be euthanized for the good of humanity. Not kidding. I've been selfish in my life, but never to the extent that I don't give a fuck if one of my children's friends die from a preventable death because I couldn't be bothered to make a bologna sandwich instead of a PB&J.

We're talking about deaths that are easily prevented by one injection from an epipen. So attempting to put these out of reach by making them too expensive or trying to take advantage of people or their parents who need them is pretty much in the top 10 of worst possible human behavior. It's not unethical. It's fucking evil.

Are there bigger issues affecting the world/country? Yes. However, the fact that this is so easily resolved by simple ethics and fucking compassion makes it a microcosm of everything wrong with our society and human nature.

Speaking of unethical, evil pieces of shit...look who's defending the price increase.

[TPRJones]

I guess if you want to kill off some poor people, that's one way to do it.

Hooray for government!

[TheCatt]

Hey, government, go fix the problem government created.

[Vince]

I don't know, the pricing doesn't bother me for whatever reason. Or I guess it doesn't bother me more than a couple dozen other things going on in our society and culture today. Too far down on my list of things to give a shit about. Probably would feel different if I or a family member had an allergy.

That's a really uninformed and bad statement.

Someone with a severe allergy needs only be exposed mildly and it can result in death. People die from their peanut allergies all the time because of cross contamination or fucking dust. Imagine having a child with an allergy so severe that merely being in a room with a peanut product can trigger an attack. Now picture trying to take that child anywhere or go to a restaurant or have the kid in school where other parents will bitch and moan that they can't give their kids PB&Js because of your kid, etc.

On a side note, the parents who bitch about allergies I regard as subhuman. I honestly think they're everything wrong with the world and should be euthanized for the good of humanity. Not kidding. I've been selfish in my life, but never to the extent that I don't give a fuck if one of my children's friends die from a preventable death because I couldn't be bothered to make a bologna sandwich instead of a PB&J.

We're talking about deaths that are easily prevented by one injection from an epipen. So attempting to put these out of reach by making them too expensive or trying to take advantage of people or their parents who need them is pretty much in the top 10 of worst possible human behavior. It's not unethical. It's fucking evil.

Are there bigger issues affecting the world/country? Yes. However, the fact that this is so easily resolved by simple ethics and fucking compassion makes it a microcosm of everything wrong with our society and human nature.

Speaking of unethical, evil pieces of shit...look who's defending the price increase.

Obviously this something you feel strongly about personally. Serious question here, can you purchase epinephrine via a prescription without it coming in an Epipen? Just wondering the feasibility of doing actual injections with a hypodermic needle rather than the Epipen. I know seconds count and all, but how feasible is it have one loaded and ready? I know my wife by her own needles for her allergy shots and lets her nurse coworker inject her. And I know people have given themselves other injections all the time.

Just looking for a solution that doesn't involve getting the government involved, as that will only allow for a government sanctioned level of price gouging (provided the proper campaign donations are received). If an alternative is found that cuts into their profits, they'll fix things. That's a much smarter way to proceed.

[Leisher]

Obviously this something you feel strongly about personally.

It was even before I had a kid with a peanut allergy (that she's thankfully outgrown). I just never understood the thought process of parents who had the ignorance to complain about what they fed their kid because it endangered a classmate. I think it's such a great example of how fucked up and selfish people can be without realizing it.

Serious question here, can you purchase epinephrine via a prescription without it coming in an Epipen? Just wondering the feasibility of doing actual injections with a hypodermic needle rather than the Epipen. I know seconds count and all, but how feasible is it have one loaded and ready? I know my wife by her own needles for her allergy shots and lets her nurse coworker inject her. And I know people have given themselves other injections all the time.

It's not about the drug as there is an alternative out there that's FAR cheaper. It's the delivery method and it's patented.

It's not realistic to have the drug sitting around and then have someone fill a needle and inject it for you during an attack. Seconds count, and what happens if you're alone and have an attack? You can't realistically fill a needle yourself. Having one sitting around might sound wise, but that needle is fragile and could break. How do you transport it?

The design used has the drug loaded and protected. It's easy to grab and you do nothing other than slam it into the person's leg and hold it there. No other steps required.

I'm sure their patent probably blocks everyone else from making anything even close to that.

[Vince]

It's not about the drug as there is an alternative out there that's FAR cheaper. It's the delivery method and it's patented.

It's not realistic to have the drug sitting around and then have someone fill a needle and inject it for you during an attack. Seconds count, and what happens if you're alone and have an attack? You can't realistically fill a needle yourself. Having one sitting around might sound wise, but that needle is fragile and could break. How do you transport it?

The design used has the drug loaded and protected. It's easy to grab and you do nothing other than slam it into the person's leg and hold it there. No other steps required.

I'm sure their patent probably blocks everyone else from making anything even close to that.

That's what I was asking about. Having a hypo loaded with the needed amount of epinephrine and ready to go and kept in a hard plastic case. It's not that difficult. Obviously you make it out of the same material that they make the Epipen out of

Not saying that's the ideal solution, but necessity is the mother of invention. And that's a much better solution than socialized medicine which leads to no medicines being developed.

[TPRJones]

Just looking for a solution that doesn't involve getting the government involved...

Just for the record, the government is already involved. It is government involvement that has caused this temporary monopoly that is allowing the company to put an absurdly inflated price on the cheaply produced life-saving medication for children and having it be enforced by government goons. Taking government out of the equation is one possible solution to the problem.

[Vince]

Just looking for a solution that doesn't involve getting the government involved...

Just for the record, the government is already involved. It is government involvement that has caused this temporary monopoly that is allowing the company to put an absurdly inflated price on the cheaply produced life-saving medication for children and having it be enforced by government goons. Taking government out of the equation is one possible solution to the problem.

Agreed.

[Malcolm]

How did that not get her fired? And her dad investigated?

Bribes. Lots and lots of bribes.

He has a peanut allergy and his grandmother decided that he probably has an allergy to other nuts as well and won't let him eat any nuts at all.

That seems like the worst possible idea. Herpetologists can build up immunity to venom by tiny, gradually increasing injection amounts. If your body can get used to shit that evolved for millions of years to murder, then it stands to reason it's got a chance against vegetables, shellfish, legumes, eggs, milk, etc. It might not be the most pleasant experience but it could take exposure effects from "potentially fatal" to "I feel like shit, get me a shot of Jack."

Having a hypo loaded with the needed amount of epinephrine and ready to go and kept in a hard plastic case. It's not that difficult. Obviously you make it out of the same material that they make the Epipen out of

You are describing an auto injector, and I guarantee those ideas are on lockdown. It's why their major competitors have to make stupid tweeks to their devices resulting in significant operational differences making market adoption ten times more difficult than it ought to be.