(For Lee Newspapers)
Consumers, parents, state officials and some members of Congress expressed deafening outrage over the doubling of the price of EpiPens, and within days America’s newest pharmaceutical villain – Mylan Pharmaceuticals – announced a generic version for half the price.
The do-it-yourself injection units filled with epinephrine are life-saving in the infrequent episodes of allergic emergency or anaphylaxis among the estimated 3.4 million people with severe allergies. However, consider another group of patients 10 times larger: the nation’s 31 million diabetics – most of whom need injections of insulin several times day, every day, to survive. These people of all ages are trying to live with rampant price gouging that the nation’s supply of insulin.
“Many more patients suffer hardship from high insulin prices than EpiPen prices,” said Dr. Bruce Rector with the Drug Pricing and Value Campaign of Doctors for America.
In a recent investigation, Lee Newspapers reported that insulin prices in the U.S. have tripled, quadrupled and soared even more in the last two years. One physician described an increase from $45 to $1,447 for one concentrated form of insulin since 2001.
“Physicians are so frustrated, and they have no idea who to believe on the reasons for the increasing prices. Everyone points their finger at someone else. I constantly get asked to explain how a medication that has been around for 100 years continues to go up rapidly. It just doesn’t make any sense,” said Rector.
Pharmacy industry watchdogs say the Machiavellian shenanigans to limit the production and distribution of insulin have been refined to an art form. One example that has become commonplace: “evergreening,” when a pharmaceutical company makes mostly minor and usually unnecessary tweaks to its insulin to extend its patent. This alone keeps makers of generic medication out of the market and robs those who need insulin out of a less expensive alternative.
“The outrageous price of insulin products is a longstanding scandal. The common thread is the abuse of drug corporations of their power over life and death,” said Peter Maybarduk, director of the Access to Medicines group for Public Citizen.
“We need comprehensive action to make medical technologies affordable for all. For starters, Congress can enact legislation against these sorts of price spikes. It is not complicated. The challenge is in standing up to the lobbying power of the pharmaceutical corporations.”
Some members of Congress agree.
“This is price gouging, plain and simple,” Sen. Jon Tester, D-Mont., said Friday. “Just last week I was talking to my childhood best friend. He was diagnosed with diabetes in the 70s. He paid $2 for a drug that now costs him $175. That’s a little higher than the rate of inflation.”
“These drug companies and middlemen are taking advantage of the marketplace,” Tester added. “I understand trying to recoup costs and making a profit, but these recent increases are totally unacceptable.”
In Texas, U.S. Rep. Lloyd Doggett, from San Antonio, said “outrageous pricing for insulin, similar to EpiPens, is a life-and-death issue which threatens more and more families.”
“Pharmaceutical price gouging is bigger than one drug or one company. We have to draw a line between profits and profiteering,” said the Democrat, a senior member of the House Ways & Means Committee.
As Lee Newspapers recently reported, all the players in the multibillion-dollar process of making, distributing and delivering insulin insist the enormous and repeated price increases aren’t their fault.
While Mylan, headquartered in Canonsburg, Penn., is the only maker of EpiPens, three worldwide drug companies make insulin.
“The big three – Eli Lilly, Novo Nordisk and Sanofi – have been getting away with evergreening and price hikes for decades,” said Merith Basey, executive director of Universities Allied for Essential Medicines. Her organization represents physicians, faculty and medical students from 67 major research universities working to ensure that the drugs developed in their labs are made available to the world’s poor.
The $600 price tag on the EpiPens “pales in comparison to the amount that people living with Type 1 diabetes spend monthly on insulin and other diabetes supplies,” she said.
“Prices are increasing, costs are not,” Basey said, calling claims that the three insulin producers don’t control the price “smoke and mirrors.”
“They control 100 percent of the market in the U.S. and an estimated 96 percent of the market globally.”
Pharmaceutical pricing games are becoming publicized, but perhaps not quickly enough to halt the organ failure, loss of limbs and death of those unable to afford their insulin.
A lot of the attention can be credited to the man viewed by most of the country as the epitome of arrogance, 33-year-old entrepreneur Martin Shkreli. The chief executive officer of Turing Pharmaceuticals’ who raised the price of a vital drug from $13.50 a pill to $750 – more than 5,000 percent. Daraprim is used to treat parasitic infection that can kill the elderly, those with AIDS and other immune-system disorders, and pregnant women.
Shkreli did everything but make an obscene gesture and stick out his tongue when he appeared before a congressional committee investigating drug prices in February. He invoked his Fifth Amendment privileges repeatedly.
Whether it was Shkreli’s antics or the seemingly uncaring comments from the EpiPen’s maker, some government regulators are finally beginning to note overpriced drugs.
There are “millions of people in America who are struggling to afford the medications that they require to stay healthy,” U.S. Surgeon General Vivek Hallegere Murthy last week told reporters who asked about price gouging by the makers of the EpiPen and life-saving drugs.
“If we really want to focus on keeping people healthy, on reducing the incidence of disease complications, then we’ve got to make sure that people can get medications at affordable prices.”
On Friday, price rip-offs on life-saving drugs became an issue in the presidential campaign.
“Over the past year, we’ve seen far too many examples of drug companies raising prices excessively for long-standing, life-saving treatments with little or no new innovation or research and development,” Democratic candidate Hillary Clinton said, outlining her multi-step plan to control and eliminate the unsubstantiated costs of life-saving drugs.
Her plan includes:
- Creating a consumer response team to monitor drug price hikes and impose penalties for unjustified increases.
- Providing for “strong new enforcement measures to respond when there are unjustified, outlier price increases that threaten public health.”
- Directly intervening to make treatments available, and supporting generic and alternative manufacturers that enter the market and increase competition to bring down prices.
- Holding drug makers accountable for unjustified price increases with new penalties and using the funds to expand access and competition.
Republican candidate Donald Trump’s campaign did not respond to a request for comments on the issue.