A EpiPen Cost Crisis

By Nathan Barton

The crisis de jour. Epinephrine injection pens, brand and popular name “EpiPens” are valuable and life-saving ways to limit allergic reactions which can kill people. They seem to be a matter of LIFE AND DEATH. (Mama Liberty may have her own thoughts on this.)

What is strange is that this lifesaving device and chemical/drug is manufactured by just one company Mylan NV. Whose CEO is the daughter of Democratic US Senator Joe Manchin. And which has raised the price of a pair of these things (which have a limited shelf life) from $100 in 2009 to $600 seven years later. (I think that is an annual inflation rate of about 80% per year – Venzuelan or Rhodesian type rate.) Mylan also “voluntarily” reduced the price “for some people” by 50%, down to “just” $300. And increased the crowd who gets them free: a family of four with income less than $97K/year, and some schools. Apparently, many people have gotten them for “free” or at greatly reduced prices for years. The CEO of Mylan blames the cost increases on the “health care system.”

Now, that is all both strange AND interesting. There are so many questions:
– What about the “system” is driving these price increases?
– Why is there only one company that makes these things?
– What alternatives are there, both to the drug and to the delivery method?
– Why is the CEO a Senator’s daughter?
– Why is the CEO of this “rapacious” drug firm a Democrat?
– How can government try to solve this problem? (Assuming that they can.)
– Why should government be the one to solve this problem?
– How can WE (patients and families) solve this problem?

I don’t even pretend to try and answer any of these questions in this commentary, at least not very well. But I do find a lot that really smells about this.

Supposedly it is the “health care insurance” system and the overall health care system and its problems that is driving the prices up, or so this senator’s daughter says. This would (I assume) include the disaster called ObummerCare, which was supposed to solve such problems. It may be that Mylan is establishing the price based on several OTHER factors, including the fact that none of their competitors are allowed to (or can afford to) offer alternatives. Frankly, in a free market and freed from the insanity of the FDA system, it would seem that a LOT of people would be willing to offer alternatives to a device you have to slam into your thigh (or your child’s thigh) to jab a needle into your body. It would seem like a LOT of people would like to be able to buy something better. But they can’t: at least not in the US. So it would seem that the FDA is an unaccused co-conspirator in this. Mylan has a monopoly enforced by a government agency, and so it can charge pretty much whatever they want, bringing in over a billion in revenues each year.. To add insult to injury, supposedly Mylan gives millions of EpiPens to “deserving people” or groups each year: to schools and institutions and to “the poor” and are now giving out coupons for $300 to “deserving people” (and claiming that insurance companies are refusing to accept the coupons), and promising to provide free ones to poor “families of four with incomes of less than $97,000” – a bizarre definition of the poor indeed!

There ARE alternatives: mostly getting the drug in quantity and using syringes to administer it: not a very GOOD alternative, but still one. You can also buy epinephrine for veterinary (animal) use at about $10 a dose. Yeah, ten dollars. And you can buy the “real quill” overseas and in Canada and Mexico for well under $100 for a pair of injectors.

The point is, the reason for this is action by government to create and maintain a situation where there is no competition. For a company that is obviously politically connected, and which no doubt is shoveling a LOT of the profits it makes from this into the political process, probably at all levels. So to expect government to “solve” this problem is like using a pyromaniac to put out his own fire.

And neither the regulation of drugs or devices (which is really the case here) is the government’s business: to even try to do so is a violation of the supposedly-sacred oaths politicians AND bureaucrats take. If we were even a somewhat-honest society, they’d be tried, convicted and made to pay what restitution is possible for the lives they’ve taken and ruined. (If we were a truly-honest society, they’d never have had the power to do this.) The people being stolen from are just another set of victims of the FDA and politicians, and the scummy crony capitalists who are parasites.

But there is more to it than that: there is also the fact that it is EXACTLY this kind of “crisis” in health care that the bureaucratic upper echelons in the FedGov (and many or most state govenments) want, and which the money- and power-greedy politicians want. Too many people will join the clamor for a “one-payer” system so that the FedGov can ensure that “everyone gets their fair share.” It is in reality just one more step to a totally, not just partially, socialized medical industry that will continue to suck the economy dry.

What can we do? Use foreign sources WHILE WE CAN. Invent ways to get around it, for the time being. But mostly, strip the government of the power to control medical devices, yes, and medicines and foods as well. And of doctors and nurses and other providers. Indeed, strip the government of everything.

Because enough is enough.

Mama’s Note: There is no question about malevolent non-voluntary government being the base cause of the problem, as with most others we face. A privileged and enforced monopoly can’t do anything good for the market, or for health care.

We do need to put this into some perspective, however. I’ve dealt with the epi-pen a good number of times in my nursing career. First, life threatening allergic reaction is actually rare. In those cases, an epi-pen might truly make the difference between life and death, but most allergic reactions don’t need that level of response.

Mylan’s marketing turned the allergy device into a must-have. Unfortunately, millions of these devices are sold (or given) to people who don’t really need them. Any nurse or doctor will tell you that most people who use them, and other things like asthma inhalers, seldom learn and practice optimal administration, so it’s a good thing it’s not usually a life or death matter.

I’m glad that they seem to have improved the epi-pen considerably since the last time I used one. Someday, in a free market, the problems with shelf life and cost will be solved easily. In the meantime, there are some alternatives available. It is the responsibility of the user/family to educate themselves, determine if and when such a device is required, and how to obtain it if so. Trusting the government to do anything rational about it may well be life threatening.

About TPOL Nathan

Follower of Christ Jesus (a christian), Pahasapan (resident of the Black Hills), Westerner, Lover of Liberty, Free-Market Anarchist, Engineer, Army Officer, Husband, Father, Historian, Writer, Evangelist. Successor to Lady Susan (Mama Liberty) at TPOL.
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