Editor's Picks

EpiPen price gouging enrages millions of users.

People with severe allergies rely on their EpiPen for life saving medical treatment, but even with insurance, they are costing users hundreds of dollars.

Anaphylaxis is a serious allergic reaction, which if not treated could result in death.  Symptoms include rash, tongue and throat swelling, lightheadedness, and shortness of breath.  A person can go from perfectly healthy to unconscious within five minutes.  The danger of anaphylaxis is that it can be caused by many different allergies, and while most symptoms occur within minutes, it could take more than an hour for a reaction to occur.  People allergic to shellfish and peanuts are commonly at risk for the reaction.  There are also those who suffer from allergies to bees, grass, or pollen, which if exposed, can lead to anaphylactic shock.  Medication allergies can also lead to these types of severe reactions.  Millions of people suffer from allergies that can cause anaphylaxis, and many of them rely on their EpiPen to save their lives.  EpiPen is an auto injector, which administers the drug epinephrine.   Each year, there are over 200,000 emergency room visits due to allergies.  10,000 of these result in overnight stays.

Unfortunately, some of the many allergic reactions result in death, as was the case with 7-year-old Ammaria Johnson.  In 2012, Johnson was playing on the playground of her elementary school when she began to suffer an allergic reaction, displaying hives and shortness of breath.  By the time emergency crews arrive, the little girl was in cardiac arrest, and she died at the hospital.  Doctors said an EpiPen could have saved the girls life.

Where there are stories of tragedy, there are also stories of hope.  Cailan Harris has suffered from a severe nut allergy for his entire life, but has only had to use his EpiPen once.  While traveling abroad, he was mistakenly served a food that contained hazelnut.  Luckily, his mother reacted quickly in administering his EpiPen, and after a short hospital stay, he was ok.  In April 2016, police officer Vincent Ceci used an EpiPen, which the department began carrying in 2014, to save a 13-year-old who was having a severe allergic reaction.

In 2007, a two pack EpiPen cost an average of 100 dollars. Now, users can expect to pay closer to 600 dollars.

Mylan Pharmaceuticals acquired the EpiPen in 2007 and has recently faced criticism for the increase in price.  In 2007, a two pack Epipen cost an average of 100 dollars.  Now, users can expect to pay closer to 600 dollars.  This is not just a one-time cost.  Epinephrine degrades quickly, and an EpiPen need to be replaced every year.  Mylan did begin offering a “$0-CoPay” card to users of Epipens, but the card is only a value of $100, and for people with high insurance deductibles it is not much financial relief.

As an allergy sufferer, I personally understand what it is like to rely on an EpiPen.  During high pollen and grass seasons, a bad day can mean severe hives all over my body, and swelling in my face and throat.  It happens in an instant, and the ability to breathe freely is gone.  Fortunately, my more recent reactions have been less severe, so a trip to urgent care was not needed.  My current EpiPen is almost out of date, and depending on the price tag, I am unsure if I will be able to refill it.  I am extremely conscious about watching out for my many allergens, but I am also realistic and understand that I cannot avoid everything.

There is one-third of a milliliter of epinephrine in each EpiPen, and one milliliter only costs one dollar to produce.

The EpiPen price comes as a shock to many users, based on the amount put into it.  There is one-third of a milliliter of epinephrine in each EpiPen.  To put this into scale, there are about 20 drops of water in one milliliter.  One milliliter of epinephrine only costs about one dollar to produce.  That means the epinephrine in a two-pack costs less that one-dollar.

Part of the problem is that there are virtually no competitors on the market, and there might not be for some time.  Due to the standards imposed by the U.S. Food and Drug Administration (the FDA) pharmaceutical companies must go through a lot of steps before selling a new drug.  One former competitor, Auvi-Q, was quite popular in Europe, so the creator brought it to the U.S.  Unfortunately, all Auvi-Q devices in the United States were recalled due to problem with users being given the incorrect dosage amount.

Now, the government could become involved.  Two democratic members of Congress are raising questions about whether Mylan overcharged the government Medicaid program for the drug.  Senator Amy Klobucher (D-MN) charged that Mylan might have misclassified EpiPens under Medicaid, resulting in a huge overpayment by the states.  It could also be resulting in an overpayment by taxpayers.  The Minnesota senator says the Centers for Medicare & Medicaid Services (CMS) lists the EpiPen as a “Non-Innovator Multiple Source Drug,” or generic drug, resulting in overpayment for the drug by states and the federal government through the Medicaid Drug Rebate Program.  “So we’re looking at both angles. Has the medical assistance program been overcharged? But also, has the company engaged in anti-competitive behavior that may run afoul of our antitrust laws.”   Minnesota Attorney General Lori Swanson says her office has asked Mylan to submit documents that justify the price hike.  “We know that schools buy the drug and the medical assistance program buys the drug,” Swanson said.

All Americans deserve full access to the medications they need-without being burdened by excessive, unjustified costs.

Presidential candidate Hillary Clinton has released a statement on the matter accusing pharmaceutical companies of putting profits ahead of patients and stated that she planned to establish a government group to monitor such increases.  “It’s time to move beyond talking about these price hikes and start acting to address them,” Clinton said in a statement.  “All Americans deserve full access to the medications they need – without being burdened by excessive, unjustified costs.”

For drug companies, there is somewhat of a catch-22.  Although their products do save lives, they are in the market of making as much money as possible.  They make money by preying on the fears of those who need the medication.  The fact is price gouging is a common practice among American pharmaceutical companies.  American drug prices are the highest in the world, and they keep getting higher each year.

Government involvement in pharmaceuticals seems to be scarce.  Although the FDA sets high standards for drug safety, there needs to be more government oversight on the price of drugs.  Generics should be available, and they should be at a significantly reduced rate.  The EpiPen is not the only prescription drug that costs an outrageous amount of money.  If current Presidential Candidates stay true to their word, a solution could be on the horizon.  Until something is done to force a change in pricing systems, users will have to continue to pay high costs for life saving medication.

Katelyn Heath, Ethics Editor
About Katelyn Heath, Ethics Editor (20 Articles)
Katelyn Heath is a third year law student and serves as the Ethics Editor for the Campbell Law Observer. She is from Salisbury, North Carolina and graduated from UNC-Charlotte with a Bachelor of Arts in History and Criminal Justice in 2014. Following her first year of law school she attended Baylor Law Schools Academy of the Advocate in Scotland. She is also currently working for Marshall and Taylor PLLC, a local family law firm.
Contact: Email