Mylan Advocates for EpiPen to be Approved as a Preventive Medication

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Mylan, the maker of the EpiPen, which recently raised costs significantly, causing an outrage among many, is now attempting to push the United States Preventive Services Task Force (USPSTF) into including EpiPens on their list of preventive medical services. While this would seem like a move in the right direction for patients (if EpiPens were approved it would result in a $0 copay), the payor (health plans, unions, employer groups, etc) would likely disagree. The reason for this? Having EpiPens on the USPSTF’s list of preventive medical services would allow the drug maker to continue to raise prices, with those costs landing in the laps of insurers or payors.

Along with patients who rely on EpiPens, Mylan would be amongst those who reap the benefits of having the medication on the preventive medical services list. This is because raising their prices would no longer result in a public outcry once patients become eligible to receive the treatment without a copay. However, it is important to keep in mind that costs could later be passed back on to consumers and patients in terms of higher premiums or higher co-pays for different drugs, according to an article in the New York Times.

Predictions About Approval

Ultimately, the decision to include EpiPens on the list of preventive drugs lies in the hands of physicians and public health experts who have been federally appointed to the United States Preventive Services Task Force. Although it can be argued that using an EpiPen can prevent a reaction that can go so far as being fatal if taken at the right time, a potential setback is that currently, there are no prescription medications for diagnosed illnesses on the USPSTF’s list of preventive medical services.

For more details surrounding Mylan’s latest efforts, check out the full story in The New York Times here.

As experts in the pharmaceutical industry, we at PBIRx are very familiar with the current situation surrounding EpiPens and are constantly reading and researching to stay on top of the latest news. If you have questions, please connect with us on social media so that we can further discuss. For additional information, contact us at (888) 797-2479.

EpiPen Costs Skyrocket, Cause Outrage

PBIRx®

Intelligent Solutions in Pharmacy Benefits

612 Wheelers Farms Road, Milford, CT 06461

(888) 797-2479

We are sure you have heard some talk about the EpiPen lately, but in case you missed it, earlier this year Mylan raised the cost of a pack to be more than $600 - a significant hike from what it originally cost when the company first purchased the rights to the drug/device in 2007 (at that time, EpiPens cost about $57 each). Since 2007, NBC News reports that the following actions have been taken:

• In 2008 and 2009, Mylan raised the price of EpiPens by 5%.
• At the end of 2009, Mylan tried a 19% price hike.
• From 2010-2013, there was a succession of 10% price hikes.
• From Q4 of 2013 to Q2 of 2016, Mylan raised EpiPen prices by 15% every other quarter.

It is no surprise that consumers are outraged over the EpiPen's new cost, as these are used for life threatening allergic reactions. With the new school year approaching many have a need to purchase an EpiPen and provide it to the school nurse, but the cost has made this increasingly difficult.

So why is the price of EpiPens so inflated?

Although it only costs about a few dollars to make (CNBC reports that only about $1 worth of epinephrine is used in these devices), there is currently NO EpiPen generic available in the United States. However, after the uproar began and Mylan faced more scrutiny from both consumers and Congress, they just announced that they will be launching a generic version of EpiPens for about half of the current price ($300). Teva Pharmaceuticals is also working on its own generic version of the EpiPen, and expects to receive approval sometime next year.

Mylan has also taken other actions to try and make EpiPens more affordable to consumers and members, such as by increasing the consumer/member out of pocket cost reduction from "up to" $100 to "up to" $300 - more details available here.

All that said, it is important for payors to understand that increased costs will be experienced, not only because of the increase in prescription costs for EpiPens, but also because of increased and conceivably unnecessary utilization or stockpiling of the brand drug. Additionally, offering a coupon for EpiPens will result in higher costs because eliminating the member copay results in brand loyalty, even though a lower cost generic will be available soon.

This is where we at PBIRx come in. We fight for our clients to get the most value for their health care dollars, and are well aware of the tactics used by Big Pharma to take advantage of consumers. If you have questions about the recent EpiPen news or would like to learn more about how we can help you during this time, please call (888) 797-2479 today.