Jessica Reino
Editor
We have hit that time of year again when the kids are back in school and the germs are thoroughly passed around from child to child and transported from school to home.
For my oldest son, it usually means that a severe asthma attack will also accompany these unwelcome companions into our house, and this year was no different.
As my husband rocked our youngest son back to sleep after a coughing spell, I sat with my oldest son for his nebulizer treatment. It was during the wee hours of the morning and my son was falling asleep with the mask over his face since his breathing had become easier.
The medicine was finally working. Even though we have been through this many times, I get upset that my son has to feel this way and that other children have to feel this way-that anyone has to experience breathing problems.
Photograph via Genta Mochizawa
I always sigh in relief that the medicine works and a trip to the local emergency room is averted. I think about how lucky we are to have access to life-saving medication and I was astounded that during this latest asthmatic episode we went through an entire box of albuterol solution.
I went to grab the box to check the re-fill amount and I noticed that the medication was made by Mylan, the company that also acquired the EpiPen back in 2007. The same company who raised prices from almost $100 for a two-pack in 2009 to around $600 for the same two-pack today.
The company that you may have heard about or read about in the news or possibly watched during the recent congressional hearing regarding this price increase. Despite this, I am still left with questions and I have a few things to say.
First off, who am I to say anything at all you may ask? Well, although my son suffers from asthma, I suffer from food allergies. I am a food allergy advocate and I wrote a book for teens on the subject. During my research for the book, I interviewed hundreds of teens and their families.
More importantly, I am also a mother who would pay anything to ensure that my child had access to life-saving medication.
With that being said, given my experiences and being a direct consumer of the product, here are my thoughts and issues.
1. I understand that Mylan is a business and a business needs to make a profit. However, when it comes to providing life-saving medication, there is a need for greater social responsibility. Part of that social responsibility is not giving exorbitant raises or bonuses to executives while increasing the price to the consumer. Mylan has definitely done some good by donating EpiPens to schools and lobbying for stock epinephrine but this is not enough. There are people every day who add value to their jobs, work overtime, and do not get an increase in pay or even a thank you. I also find it disconcerting that the extreme price increase occurred just after one of the largest competitors of the EpiPen was pulled from the market.
2. I have been diagnosed with allergies for quite some time and I have always carried two EpiPens. During those years, I have not seen a significant improvement in the product itself. I may even be willing to pay more if there were certain improvements. For instance, does the plastic case need to be so bulky or is it even necessary? Could there be an auto-lock so that the needle would not mistakenly eject and therefore the case would not be necessary and bring the total cost down? As for the solution itself, it is very difficult to determine whether or not the EpiPen solution is viable and still good after exposure to extreme hot or cold. I personally have taken my pens to the pharmacist on a few occasions and it was “inconclusive” so I erred on the side of caution and had to discard those and get new ones.
3. Having to discard questionable EpiPens also brings up the issue of having to have multiple EpiPens at multiple locations in general, which was not really brought up during the questioning or interviews. Those who suffer from severe allergies usually have more than one place where they store their EpiPens in case of emergencies. Separate prescriptions could be at home, school, church, work, and carried on your person, depending on the age of the allergy sufferer. So realistically, we’re talking hundreds to thousands of dollars being spent at a time. Additionally, the expiration date of EpiPens are a year, so those that go unused, need to be discarded and purchased again every year. I find it extremely circumstantial that after a congressional hearing Mylan all of a sudden has plans to increase the expiration dates and also produce a generic version for half of the cost.
Photograph via Roger Burkhard
4. In an effort to defray costs to the consumer, a proposal was made to try to get Epi-Pens on the Federal Preventative List which in essence would allow the selling price of the EpiPen to remain the same without passing the cost on to the consumer. This may seem like a good idea, but who do you think is going to end up paying for this? That’s right the consumer! The cost doesn’t just go away and I guarantee health insurers are not going to be happy picking up the costs (Why would they? They are a business too.) So guess what will end up happening? The costs will end up being dispersed to other areas like office visit co-pays, co-insurance for labs, so looks like we, the consumers, will pay for it anyway. How is this helpful?
5. My biggest issue is how are we really going to fix this? We can place blame and play the “Who’s on First?” Game forever, but what does this actually accomplish? We need action to remedy the situation now. Maybe this means taking a look at patent laws and investigating that. Maybe it means promoting more entrepreneurship grants. Epinephrine is the only treatment for an anaphylactic reaction and it has been around for quite some time. It should not take long for generic auto-injectors to make their way to market it’s not a brand new drug.
Let’s get going on this because time is ticking and so is the expiration date on those Epi-Pens.
More About Jessica Reino: Kidlit writer, editor for @pandamoonpub, foodallergy advocate, wife and mom to two amazing boys who keep me on my toes. Find out more at www.jessicareino.me.