The EpiPen that cost $75 in 2001 costs over $300 today

[Pea-n-Me]

Teva Pharmaceuticals is working on a generic equivalent, but it's not approved yet.

http://www.pharmamanufacturing.com/industrynews/2016/tevas-generic-epipen-will-be-delayed-by-fda/

Another interesting piece to the puzzle!

I had to search for it, but this helps explain what the hold up is on generics.

http://www.disboards.com/threads/scotus-case-on-patents-could-influence-drug-affordability.3505306/

 

[PollyannaMom]

I think it's pathetic and greedy. I get things being expensive when they're new, because of all the research costs involved in getting those first batches produced, but after all this time, it can't cost that much to make more!

 

[MaryLovesPoohBear]

They generally come in a package of two with a "trainer."

 

[LisaR]

and they expire quickly :/

I absolutely refuse to take epi-pens with an expiration date shorter than one year. I will make the pharmacy order a new batch or I will call all of our local pharmacies and find the one that has the longest expiration date. When the Auvi-Q injectors were out (they have since been recalled) I called them directly when the expiration date was only six months out. They shipped one with a year expiration directly to my pharmacy at my request when my pharmacy was less than helpful. Our batch expires in December so I will start the hunt for new ones in late October/early November so I can make sure I get the best expiration date available. No clue what ours will cost. We haven't met our deductible. Maybe I'll wrap them up and give them to my son for Christmas. Here, we spent $600 on you!

 

[bcla]

This is interesting! The manufacturer is apparently based in the Netherlands.

Anyone know exactly how this works?

They're not really based there. It's just a headquarters and possibly just done out of tax strategy. Their manufacturing is in the United States for the most part.

A lot of companies pick a symbolic headquarters for one reason or another, even if they're not really doing much there other than keeping a small office. I've interviewed at a company that was legally based in Singapore, but the bulk of their operations were in Silicon Valley.

 

[trip]

This is interesting! The manufacturer is apparently based in the Netherlands.

Anyone know exactly how this works?

Not sure but it probably is all about taxes. How many companies have their headquarters in a tax haven?

 

[Hikergirl]

Here's a thought, who does the testing on the effectiveness of the medication after the expiration? Is it the manufacturer? Obviously it is in their best interest for the medication to "expire" quickly.

I literally just remembered that I found a 2 pack of epi-pens in ds drawer and put them in the bathroom so I could return them to the pharmacy for disposal. I am looking at them right now, expired in 2013 (yes ds does not clean his drawers out often LOL) and the solution is still clear, not discolored at all. I don't know if it means anything but thought it was interesting.

I recently looked up if it was okay to take vicodin after the expiration and it said it could be could up to 5 years after. I wonder about the epi-pens


https://www.oakstreetmedical.com/easyblog/entry/ask-a-doctor-is-my-epipen-still-good

 

[Pea-n-Me]

They're not really based there. It's just a headquarters and possibly just done out of tax strategy. Their manufacturing is in the United States for the most part.

A lot of companies pick a symbolic headquarters for one reason or another, even if they're not really doing much there other than keeping a small office. I've interviewed at a company that was legally based in Singapore, but the bulk of their operations were in Silicon Valley.

I'm not the right person to address this since it's far from my area of expertise. But maybe someone else here will be able to.

The article says the company that holds the patent and makes the EpiPen, i.e. Mylan, is based in the Netherlands. I take that to mean "headquartered". Why they're there, I have no idea.

But my question is, why does Canada pay significantly less for the exact same thing, from the same company?

ETA no doubt it's some sort of business arrangement, but this is why we now have the Attorney General looking into it, I suppose. * Looks like a video was added to the article linked in the OP which has the Attorney General discussing it - oops it's Senator Blumenthal from CT in the video. Souds like a big part of the problem is the FDA and other regulatory agencies, but Mylan, according to Sen. Blumenthal, made $1.2 billion on this drug, so they're pressuring the manufacturer to lower their costs voluntarily. (Let's not hold our breath!)

 

[bcla]

Another interesting piece to the puzzle!

I had to search for it, but this helps explain what the hold up is on generics.

http://www.disboards.com/threads/scotus-case-on-patents-could-influence-drug-affordability.3505306/

CFC-based inhalers used to be pretty common, but now that they're not allowed in the US (the waiver expired) there's basically only one company that has an inhaler that works properly. They're guarding their patent tightly. When I needed an albuterol inhaler, the wholesale cost was maybe $10.

http://www.reuters.com/article/us-asthma-costs-inhalers-idUSKBN0NW1OV20150511

The last time I needed one, the doctor gave me a sample of Sybicort. It was more than I needed, but the doctor gave them out rather than asking the patient to pay ridiculous out of pocket costs.

 

[bcla]

I'm not the right person to address this since it's far from my area of expertise. But maybe someone else here will be able to.

The article says the company that holds the patent and makes the EpiPen, is based in the Netherlands. I take that to mean "headquartered". Why they're there, I have no idea.

But my question is, why does Canada pay significantly less for the exact same thing, from the same company?

Because the Canadian and provincial governments effectively set the price, and they have no other option other than to accept it. They might also make it easier for generic equivalents to be on the market.

http://www.nytimes.com/2013/10/13/us/the-soaring-cost-of-a-simple-breath.html

Unlike other countries, where the government directly or indirectly sets an allowed national wholesale price for each drug, the United States leaves prices to market competition among pharmaceutical companies, including generic drug makers. But competition is often a mirage in today’s health care arena — a surprising number of lifesaving drugs are made by only one manufacturer — and businesses often successfully blunt market forces.​

If there's real competition (such as ibuprofen) then there's not all that much that can be done to jack up the prices. However, when there are patents or there's only one company interested in making a product, then that's a different matter. You'd think maybe another company might step in, but even the generics need some sort of approval, and the cost of development (reverse-engineering the manufacturing) and testing may not be made up, especially when they intend on competing on price.

 

[Music City Mama]

It really is obscene.

Here is a petition that you can sign that will also send a letter to your state's congress members. I received an automated reply from one of my senators yesterday confirming receipt of my email that I sent through this:

www.petition2congress.com/20720/sto...

 

[Hikergirl]

http://www.ncbi.nlm.nih.gov/pubmed/10808186

According to this you should use in-date epi-pens but if all you have on hand is an expired one as long as its not discolored its okay to use. It may not be as effective as a new one, but its better than having none.

 

[Bilberry]

Yeah, it isn't good to see. My sister was complaining about the new higher price increase in the epi-pen a few months ago to the family. She buys some for my nephew.

It seems to be the common thing to do though these past decades, raise medical costs. It goes in line with the $30 cokes, $200 bandaids, or some lab tests that cost the equivalent of the new car. Not to mention million dollar cancer treatments, heart disease costs, etc.

There seems to be little real interest from politicians, health officials, insurance firms, etc in addressing and changing the system due to the ever rising medical drug and hospital costs.

It is good though I feel that more people question health officials about costs and how diseases are addressed. With more and more health companies announcing they are dropping out and not offering health insurance due to ever rising costs, and not being able to make a profit, I imagine eventually the bottom will fall out of the gold rush.

There are a number of articles that provide different ideas on why American health costs, medical and drugs are so high. Time magazine had an article that many quote on the topic. Saw this also ~

Why Are US Health Care Costs so High?

http://articles.mercola.com/sites/articles/archive/2013/08/14/us-health-care-costs.aspx

 

[kimblebee]

I used to work for an online pharmacy, the largest one in Canada actually..PLEASE do not buy any medication online where you are not required to provide a prescription.

As to why Canada gets the drugs so much cheaper, is price control. The government has set up several ways to make sure our prices stay fair..prices can't increase more than the cost of inflation, new drugs can't cost more than the median cost of the drug worldwide..that sort of thing.

If you need epi pens, definitely look online. It is safe IF you use a reputable company. Make sure they need a prescription, make sure they tell you where the drug is coming from, make sure they won't give you more than a three month supply (that's all the FDA allows to cross the border at one time).

 

[Hikergirl]

I used to work for an online pharmacy, the largest one in Canada actually..PLEASE do not buy any medication online where you are not required to provide a prescription.

As to why Canada gets the drugs so much cheaper, is price control. The government has set up several ways to make sure our prices stay fair..prices can't increase more than the cost of inflation, new drugs can't cost more than the median cost of the drug worldwide..that sort of thing.

If you need epi pens, definitely look online. It is safe IF you use a reputable company. Make sure they need a prescription, make sure they tell you where the drug is coming from, make sure they won't give you more than a three month supply (that's all the FDA allows to cross the border at one time).

I looked yesterday and found an online pharmacy that had the epi-pen for $140, it did require an Rx.

 

[NCDisneyMom]

Here's a thought, who does the testing on the effectiveness of the medication after the expiration? Is it the manufacturer? Obviously it is in their best interest for the medication to "expire" quickly.

I literally just remembered that I found a 2 pack of epi-pens in ds drawer and put them in the bathroom so I could return them to the pharmacy for disposal. I am looking at them right now, expired in 2013 (yes ds does not clean his drawers out often LOL) and the solution is still clear, not discolored at all. I don't know if it means anything but thought it was interesting.

I recently looked up if it was okay to take vicodin after the expiration and it said it could be could up to 5 years after. I wonder about the epi-pens


https://www.oakstreetmedical.com/easyblog/entry/ask-a-doctor-is-my-epipen-still-good

I have no idea about Epi Pens in particular. However, my father used to be in pharmaceutical manufacturing (although he's been out for over 20 years now). He has told me, in the past, that most medications will still be good for at least 6 months after their expiration date. No, I wouldn't want to mess around with the epi pen expiration, since it's life saving, but it's good to know if you happen to have one laying around.

What I find ridiculous is that, after I had surgery earlier this year, I was able to get a narcotic pain killer for $10. Yet, my son's epi pens were going to cost me $650. I joked that I should go out and sell my unused painkillers to pay for them.

And here is the kicker, to me. I called Mylan about the coupon. It says "pay $0", but it's really just $100 off which, if you have a co-pay, will bring you down to $0. Otherwise, it's $100 off the total cost. I asked if they had any assistance programs. Sure, but only if you have no insurance and fall below the poverty level. So all of us with crappy insurance get nothing.

 

[Geoff_M]

As to why Canada gets the drugs so much cheaper, is price control. The government has set up several ways to make sure our prices stay fair..prices can't increase more than the cost of inflation, new drugs can't cost more than the median cost of the drug worldwide..that sort of thing.

I'm not saying it's the case with the pen, but artificial price control also has the unintended consequence of cost-shifting the prices of drugs to markets like ours. If your COGS goes up 6% next year for a given product, while inflation was only 3%, you're going to want to make that extra 3% up from somewhere else. We help subsidize drug costs for the rest of the world.

 

[Paula Sedley-Burke]

Forgive my ignorance I have read this in amazement so am I right in thinking that in the US and Canada you get no help from the Government for medication even for children?? Omg I am so shocked. I live in the UK you see. We have a free NHS system for all. I thought they might provide at least for children. How do you guys afford it!

 

[The Mystery Machine]

This is interesting! The manufacturer is apparently based in the Netherlands.

Anyone know exactly how this works?

Not sure but it probably is all about taxes. How many companies have their headquarters in a tax haven?

It has to do with Intellectual Property stuff as well.

I saw this documentary, cannot recall name off hand, and they were talking about how Pfizer the drug company was able to post financial losses in USA while making millions overseas.

Here is an example. It is more messy than this however I think quote pretty much nails it.

"Pfizer has used transactions between companies within its group to allow an Irish subsidiary based in Ringaskiddy - Pfizer Ireland Pharmaceuticals - to buy the rights to patents developed in the United States and then use them to make drugs which are sold back to U.S. affiliates."

http://www.reuters.com/article/us-pfizer-tax-insight-idUSKCN0T51ZS20151116

 

[mom2rtk]

I'm not saying it's the case with the pen, but artificial price control also has the unintended consequence of cost-shifting the prices of drugs to markets like ours. If your COGS goes up 6% next year for a given product, while inflation was only 3%, you're going to want to make that extra 3% up from somewhere else. We help subsidize drug costs for the rest of the world.

Yep, that.

You're welcome, world.