Mylan CEO set to defend EpiPen prices amid public outcry

Users of EpiPen, the life-saving drug used to prevent potentially fatal allergic reactions, are left enraged after a price increase. More people are paying out of pocket for the $600 packs, which expire every 12-18 months, because of the prevalence of high-deductible insurance plans.

But until prices come down, experts urge people with allergies to steer clear of DIY hacks, even if they look like lifesavers.

Now almost every state recommends or requires that schools have an epinephrine injector on hand; under the so-called “EpiPen Law” the White House gives funding preference to schools that stock the devices - and while schools are not required to choose one autoinjector over another, EpiPen’s near monopoly in the market ensures that most schools are stocked with the brand-name devices.

Republican Rep. Scott DesJarlais of Tennessee, a physician, told Bresch that she was “trying to make us feel good” about the generic version and other programs, but that he doesn’t feel good about it.

“You got a hefty increase”, she said.

“I know there is considerable concern and skepticism about the pricing”, she told the panel. She says some think the company makes $600 off each EpiPen, but that is not true. Of that $100 is profit – $50 per pen. The list price for a two-pack of the pens is $608, up about 500 percent in a decade. When asked whether Mylan or Bresch should receive some sort of punishment, Chaffetz demurred and pointed toward the idea of more generics. Prices range from $69 in the United Kingdom to $210 in Germany.

In a Wednesday hearing, the House Oversight and Government Reform Committee expressed a rare bipartisan interest in regulating the pharma giant.

Before she testified, a stone-faced Bresch was lambasted by the ranking minority member of the committee, Rep. Elijah Cummings, D-Md., who told her he wasn’t “impressed” by her prepared remarks.

Bresch said the company was making far less on the drug than the public believed.

“They sat at this very witness table with absolutely no remorse”, he said. Comparing Bresch to Shkreli, Cummings said Mylan acquired EpiPen and then “used a simple but corrupt business model” seen throughout the pharmaceutical industry.

Warren and a number of other politicians, including Cummings, believe that pharmaceutical companies use patient assistance programs to preserve drug prices. A recent poll of 51 physicians conducted by RBC Capital found 37 percent of patients who needed an EpiPen are unable to pay for it. “And today, approximately 85 percent of EpiPen patients pay less than $100 for a two-unit package and a majority pay less than $50”, she said. Bresch also said Mylan will soon be asking the U.S. Food and Drug Administration for approval on a new device with a longer shelf life, which would cut down on replacement costs for the device.

Bresch explains there’s more to an EpiPen than meets the eye. Again, this failed to impress the committee. But critics have said the coupons, discount cards and patient assistance programs aren’t real solutions because many customers won’t use them or won’t qualify for them. On Tuesday, the West Virginia state attorney general said his office was investigating Mylan over potential antitrust violations and accusations that it may have overcharged the state Medicaid program for the product. She instead suggested a planned generic version the company will market at $300.

Earlier this month, NY state’s attorney general Eric Schneiderman launched an investigation of Mylan with an eye to possible anti-competitive practices by the pharmaceutical giant in the sale of EpiPen to local school systems. “In that way it may actually be anticompetitive”, the group said in a statement on Bresch’s testimony.

As in the past, Bresch sought to shift the blame for the EpiPen’s price.

Bresch defended her company’s practices. If you want to come to Washington, if you want to come to the state capitols and lobby us to make us buy your stuff, this is what you get.

Mylan CEO Heather Bresch testifies on Capitol Hill in Washington, Wednesday, Sept. 21, 2016, before the House Oversight Committee hearing on EpiPen price increases. Joe Manchin, a West Virginia Democrat. He now serves as the state’s senior US senator.