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Title: Cash Price of Epipen ... INSANITY!!!!!
Post by: ctmartin on April 09, 2016, 11:17:13 AM

HI, all,

Haven't been here for a few months, so I am not sure if this has been discussed already but couldn't find it when I searched.  Calling around for epipen prices/expiration dates and have come to find in a year that prices have gone up almost $200! (and yes, this is with the $100 off coupon).  Has any one else noticed this?  I know many have insurance coverage and we are probably among the few whose cr@ppy insurance does not cover, but cannot understand how a 2 pack can cost $634!!!!!?????  Is this because of a higher demand due to auvi Q recall? 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: momma2boys on April 09, 2016, 12:58:14 PM
Do you have a CVS nearby? If so, ask them to run it through the new script save discount card. Here it brings it to about $350. Horrible still, but better.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ctmartin on April 10, 2016, 09:04:13 PM

Thank you so much, momma!  I will try it!  I just saw my walmart receipt from 11/13 and it was $250 for a 2 pk, and when I called yesterday it was $594!  I am not partial to any one pharmacy ... I just usually check around to find the latest expiration date.  I will report back later ;)
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ctmartin on April 10, 2016, 09:14:15 PM

Hi, Momma,

I don't know where you are, but when I type in epi pen 2 pk and my zip code, it's still coming up $525-$574!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: momma2boys on April 10, 2016, 10:29:42 PM
Ugh that is ridiculous! Was that just cvs price or through script save? My other suggestion would be to call the company directly. The drug companies all have patient assistance programs and I know many people who end up getting their drugs free, mailed to them every 3 months, including advair inhailers and insulin pens.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Penny on April 11, 2016, 01:10:42 AM
Outrageous!  I just bought one here in New Zealand.  US$120 over the counter (single epi-pen) no prescription needed, so if you know anyone travelling here.... 

Crazy idea but it would be cheaper to fly to NZ if you need to buy a quantity. However, though they're OTC, you still have to talk to the pharmacist in order to purchase it.  Lately, airfare from LAX to NZ has been about US$800 roundtrip.

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on April 11, 2016, 12:58:46 PM
They cost around $100 each over the counter (no prescription) in Canada too. And people complain that is too expensive already... What happened to make the price skyrocket in such a short timeframe in America?  Aren't there any regulating bodies that control medication prices there?  In 2013 my 2-pack was close to $300 in America when I needed a refill there.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: CMdeux on April 11, 2016, 01:01:57 PM
Aren't there any regulating bodies that control medication prices there?



Er... not really.

See:  Shkreli, Martin.

And, um--  welcome to unfettered free-market capitalism?   :disappointed:


Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ctmartin on April 11, 2016, 02:50:15 PM

spacecanada ... that is what i was going to ask next!  thank you!!  we will be in montreal and toronto in july ... thinking of having my daughter self-carry our two that are still good (they don't expire until sept- our other two expired two weeks ago) and refill in canada.  you really don't have to have a prescription there??

this is just my thought, but perhaps the recall on auvi-Q and the increased demand for the epipen caused the prices to go up?  as i said, when i paid in late 2013 it was $250 for a 2 pk.  now $634?????  thieves!!!!!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hedgehog on April 11, 2016, 03:09:56 PM
Pharmaceuticals don't follow the normal laws of supply and demand.  The price is more of an effect of demand and need.   If a drug is needed, absolutely necessary, prices will remain high, because people must pay it or suffer the consequences, which may even include death.  Supposedly this is because it costs so much to develop the drugs, and they need to recoup that cost.  However, they will often sell the same drug, by the same manufacturer, for less in other countries.  So really, it is just gauging, because it is legal to do so.

And I have read (can't state for fact how true it is, as I don't remember where, but it seems to fit) that if a drug is needed by a small enough segment of the population, that they may stop manufacturing altogether, because there is no money to be made by it.  Even if that drug saves lives.  And they still hold onto the patent, so no one else can makeit either. 

For the most part I am all for free market, less govt interference with commerce.  However, when it is as morally reprehensible as this turn a profit at the public's expense, I wish the govt would step in and make some common sense laws.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on April 11, 2016, 06:28:15 PM
No EpiPen prescription is required in Canada.  We get prescriptions so we can have the cost covered by third party medical insurance, but it isn't necessary if you intend on paying out of pocket.  Also, you have to declare them when going back over the border.

Note that buying medication here and bringing it over the border is frowned upon by many.  Though I doubt over the counter meds are the biggest problem.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ctmartin on April 11, 2016, 06:51:34 PM

Thanks everyone, especially spacecanada!  Not sure what we will do, but thankfully we have options now.  I found that even with the wellscript card AND the epi coupon, it was still $434 ... way too expensive ... especially when we have to buy 2 sets.  I also found a Canadian pharmacy online (Canadianpharmacymeds.com) and was wondering if anyone has had any experience with this?  I asked and they said it is not generic epi ... that it is epipen brand!  I have been paying out of pocket for years (we have a whole closet of expired pens, as we have been buying them for the last 8 years and have only used one, knock wood) and it has always been unreasonable.  I wish I had looked into alternatives sooner.  However, now it is not just unreasonable, it is unacceptable!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Penny on April 11, 2016, 07:11:14 PM
A thought:  I've heard that here in NZ, some people who need to carry epi ask the doc for a script for a vial of epi and a couple of syringes as it is SO much cheaper. Obviously it wouldn't work for kids but why not for adults? It's not difficult to give yourself an injection....
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on April 11, 2016, 07:41:53 PM
It's not difficult to give yourself an injection....
I beg to differ, particularly when you are delusional, spaced out, weak, and uncoordinated during a reaction.  Even an EpiPen becomes challenging to use.  Allerject was the best because it gave you audio instructions, but still hard to coordinate in a reaction.  (I have had the unfortunate experience of using both types of autoinjector on myself in a reaction.)  I would never choose the phial and syringe route if an autoinjector was available, regardless of cost.

CT - no generic exists in Canada. I would still opt to get one in person vs. online.  I don't know what customs /importlaws are involved and you may want to investigate that on your own before going the online (and shipped to America) route.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: SilverLining on April 12, 2016, 09:59:41 AM
A thought:  I've heard that here in NZ, some people who need to carry epi ask the doc for a script for a vial of epi and a couple of syringes as it is SO much cheaper. Obviously it wouldn't work for kids but why not for adults? It's not difficult to give yourself an injection....

Disagree. I couldn't even walk a straight line when I needed epinephrine.

As SpaceCanada said, a prescription is not needed here to purchase unless you are getting it covered by insurance, or claiming on your income tax.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: YouKnowWho on April 26, 2016, 10:31:01 AM

Thanks everyone, especially spacecanada!  Not sure what we will do, but thankfully we have options now.  I found that even with the wellscript card AND the epi coupon, it was still $434 ... way too expensive ... especially when we have to buy 2 sets.  I also found a Canadian pharmacy online (Canadianpharmacymeds.com) and was wondering if anyone has had any experience with this?  I asked and they said it is not generic epi ... that it is epipen brand!  I have been paying out of pocket for years (we have a whole closet of expired pens, as we have been buying them for the last 8 years and have only used one, knock wood) and it has always been unreasonable.  I wish I had looked into alternatives sooner.  However, now it is not just unreasonable, it is unacceptable!

Our new allergist suggested this site BTW.  He said many of his patients are struggling with the ridiculous cost of epi pens no matter how great their insurance is.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ctmartin on May 02, 2016, 10:39:18 PM

Good to know!  We will be in Montreal and Toronto in July, so will buy while we are there, but I plan to use this site in the future!!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: CMdeux on May 03, 2016, 11:21:18 AM
SO the one thing that I've always worried about with mail order and rescue meds is temperature excursions during shipping-- how do they manage to control that?? ???

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on May 03, 2016, 12:06:04 PM
DH actually looked into this, and while we wouldn't do it in the winter, he read enough to suggest it might not be the cover need think it would be. But he didn't type things up like I asked, and that info is pretty much gone now. It's been over a year.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on May 03, 2016, 06:46:45 PM
Research has proved that cold temperature excursions won't adversely affect EpiPens.  I don't have a link to the study but I know many Canadians were happy with that.  It is the heat I would be concerned about with shipping, especially in summer to Southern States.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: CMdeux on August 20, 2016, 03:46:20 PM
Hey-- so I know that this has been all over the news this year with back-to-school time upon us. 


I've really been heartsick about this-- I know that there will be kids whose parents choose to not tell the school about a child's allergy simply because they can't afford to provide "extra" autoinjectors to the school.   :disappointed:



http://www.pbs.org/newshour/rundown/as-epipen-prices-skyrocket-consumers-and-emts-resort-to-syringes-for-life-threatening-allergies/

Locally, sticker-prices of twinpacks are up to about $600 a pack this year-- so for someone without prescription coverage, out of pocket costs for a set of three twinpacks (one for school, one for each parent, or home and caregiver sets-- this is pretty minimal coverage that doesn't account for a fourth or fifth set for after-school care and/or sports without a parent present); adds up to about 1800 USD.

 I know that some school policies mandate autoinjectors-- and certainly might for children to have epinephrine in classrooms rather than in a nurse's office.  I can see why for self-carry, especially prior to high school. 

Has anyone had luck getting a school to accept vials and syringes?   I mean, they HAVE for diabetic children, so they can, I guess.  Then again, insulin isn't the same thing, since the speed of administration isn't quite the same level of critical, meaning that a nurse can keep and dispense medication as needed.  Not so with asthma meds and epinephrine, or... seizure meds, maybe?

I'm really wondering what parents who quite literally CANNOT afford this expense are going to do. 
 



Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on August 20, 2016, 08:02:19 PM
Our school actually told us last year if money were a problem that they have enough epi to cover DS and kit to worry about providing a dedicated set for him for school (knowing he also self carries). This was after I bought them and paid $80 then. Sigh.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Ciel on August 21, 2016, 05:45:38 PM
I'm in Ontario and you can get Epipens OTC without a prescription. I don't have a drug plan so I pay out of pocket and sometimes I get a prescription, sometimes I don't bother. I'm not sure what the cost is, I can't remember what I paid last time, but I think it was around $200 for 2 EpiPens. I would want to get mine in person rather than through the mail, myself.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Mfamom on August 22, 2016, 08:59:25 PM
http://www.northjersey.com/news/as-epipen-cost-skyrockets-400-percent-lawmakers-call-for-price-gouging-investigation-1.1648920?utm_source=dlvr.it&utm_medium=twitter
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on August 22, 2016, 09:09:18 PM
The crazy cost increase has only affected America.  The price of an EpiPen in Canada is government-controlled and has remained fairly consistent for MANY years at $90-110 each, depending on your location and pharmacy dispensing fees. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: CMdeux on August 22, 2016, 09:40:53 PM
I guess you aren't getting the same "value" that we Yanks are out of our epipens.  Or maybe Canadian lives are worth less.  I'm not sure.   :thumbsup: :tongue:


In all seriousness, it is picking up steam this story-- and apparently lawmakers are pushing for there to be an inquiry into Mylan's pricing rationale.  THAT ought to be interesting.   :watch:  Yes, do tell us why it is that about $7.50 worth of materials warrants a $700 price tag.

 DO.  I'd LOVE to know.  Because I'm sure that "the value that the product represents" must-- surely-- not have meant that you can EXTORT more money from terrified parents and the "value" of children's lives is being nicely reflected in your share price and the "features" are mostly there for your stockholders.  SURELY not. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: CMdeux on August 22, 2016, 10:07:44 PM
Interesting-- I really, really, really hope that this device makes it to market approval.  It sounds TERRIFIC.

http://fortune.com/2015/07/21/epipen-alternative-medicine/

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: GoingNuts on August 23, 2016, 05:58:42 AM
This was the lead story on my local newsradio this morning!  :thumbsup:
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on August 23, 2016, 07:37:15 AM
It is picking up steam!  Bernie has spotted about it on FB and so has my senator, Amy Klobuchar. I love her so much.

Friends who do not deal with a life threatening allergy are posting about this on FB.

Wow. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hedgehog on August 23, 2016, 08:19:24 AM
Seems to be part of this a**hole's legacy.  :rant:

https://www.washingtonpost.com/news/to-your-health/wp/2015/09/21/ceo-of-company-that-raised-the-price-of-old-pill-hundreds-of-dollars-overnight-calls-journalist-a-moron-for-asking-why/
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hezzier on August 23, 2016, 09:38:46 AM
My FIL called the other day to make sure I was aware of it...he saw it on the news.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 24, 2016, 01:26:38 PM
ajasfolks2 has been adding to the Twitter voice on this topic . . .

 :bye:
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: maeve on August 24, 2016, 02:47:14 PM
It is picking up steam!  Bernie has spotted about it on FB and so has my senator, Amy Klobuchar. I love her so much.

Friends who do not deal with a life threatening allergy are posting about this on FB.

Wow. 

Sen. Mark Warner has also been speaking about this. He has a child with severe allergies according to a news article I read. One senator who is unlikely to speak about it is Sen. Manchin considering his daughter is the CEO of Mylan.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ctmartin on August 24, 2016, 10:37:23 PM

hi, everyone ...  the fact that we were in canada this summer, strolled into a pharmacy without a prescription, and walked away with two epipens at a cost of $206 makes this whole thing in the US that much more reprehensible.  while i know many get their pens through health insurance coverage, i have spent the last 9 years paying out of pocket and watching prices go up and expiration dates get shorter.  the pens from canada had an expiration date of 16 months ... unheard of here!  on our recent visit to mt. sinai, our doctor handed us a two pack like it was a reward sticker after the appt.  THAT IS AS IT SHOULD BE ... these things do not cost anything to produce!!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: my3guys on August 25, 2016, 05:51:28 AM
This article was floating in my facebook feed last night:

http://www.nbcnews.com/business/consumer/mylan-execs-gave-themselves-raises-they-hiked-epipen-prices-n636591

Proxy filings show that from 2007 to 2015, Mylan CEO Heather Bresch's total compensation went from $2,453,456 to $18,931,068, a 671 percent increase. During the same period, the company raised EpiPen prices, with the average wholesale price going from $56.64 to $317.82, a 461 percent increase, according to data provided by Connecture.

Oh.my.god.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: GoingNuts on August 25, 2016, 06:16:41 AM
http://www.ecowatch.com/epipen-scandal-1985272438.html

*Shuddering at the advice to keep two in the car*
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hezzier on August 25, 2016, 06:39:54 AM
Mylan CEO Heather Bresch's total compensation went from $2,453,456 to $18,931,068, a 671 percent increase.

Oh.my.god.

You know because $2.4 m wasn't enough to live on...it's sickening
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on August 25, 2016, 07:19:45 AM
Those were my thoughts exactly.

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hezzier on August 25, 2016, 07:54:43 AM
Things I have seen this morning...Mylan increased their patient assistance coupon to $300 and Sarah Jessica Parker has apparently ended her relationship with Mylan due to the price increase...
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: momma2boys on August 25, 2016, 08:16:34 AM
It is definitely huge news everywhere now, which is great!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: starlight on August 25, 2016, 08:34:04 AM
The sheer amount of attention...is weird, isn't it? I definitely feel it's overdue, I've felt the price raise should've been made public a long time ago, but am I the only one feeling like this? Dissonance? And that the fallout is way bigger than expected? Usually when allergy folk get attention, it comes with a pretty significant backlash toward us. Or it's only taken up by people who are allergic or have an immediate family member allergic. Now it seems like everyone's suddenly on our side (or at least fighting against the same foe).
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: rebekahc on August 25, 2016, 09:18:59 AM
I think the whole Martin Shkreli thing paved the way for the response we're getting.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hezzier on August 25, 2016, 11:43:01 AM
Just to show the stark contrast of pricing, today I paid $1.15 for a 10 supply of antibiotics for DS.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: candyguru on August 25, 2016, 10:45:49 PM
You can also order the epi-pens from CanadaDrugs.com

" the Canadian price has remained constant for more than five years, thanks to regulation by the Patented Medicine Price Review Board, which has strict control over the prices pharmaceutical companies can charge for their products"

The Patented Medicine Price Review Board is a department of the Government of Canada:  http://pmprb-cepmb.gc.ca/home
So for those Republicans saying "universal health care" is so terrible, take note we love 'universal health care" here in Canada

================================================================================

When Darby Leigh found out she’d need to start carrying an EpiPen this summer due to a medical issue, the Florida resident was stunned by the cost.

“I couldn’t afford it,” said Leigh, 35. “They wanted to charge about $600 for two EpiPens and I couldn’t do that. I started looking elsewhere.”

Her husband, Jonathan, originally from Brampton, suggested looking north of the border for cheaper options. She was able to buy a two-pack for about a third of the cost from CanadaDrugs.com, an online pharmacy based in Winnipeg.

With the price of an EpiPen in the United States reaching unaffordable heights for many families, some Americans, like Leigh, are turning to Canada.

Mylan, the U.S. pharmaceutical company that distributes the EpiPen, announced Thursday it would lower the cost of the severe allergy treatment drug for some patients, following pressure from groups such as the American Medical Association and presidential candidate Hillary Clinton.

But the actual price of the product, which hit $609 per pair in May — a 400 per cent increase since 2009 — won’t change. Insurers and employers that pay the bulk of the EpiPen cost for many patients will continue to do so, contributing to higher health insurance costs.

Darby Leigh of Florida, left, and her husband, Jonathan, of Brampton, purchased a pair of EpiPen injectors online from Canada due to exorbitant prices in the United States, where they live. Prices have soared to $600 for a pair south of the border, while the cost of a single injector is about $100 in Canada.

Mylan has consistently raised the price of EpiPen injectors since taking over the rights to the product in 2007, when a pair of syringes cost $93.88.

The cost of a single EpiPen in Canada is about $100, according to a spokesperson for Pfizer Canada, which distributes the drug locally.

“Canadians can rest assured that the price will not be increased like it has in the U.S.,” said Manon Genin, manager of corporate affairs for the company. “There are mechanisms in place in Canada to make sure that kind of situation doesn’t happen.”

Genin said the Canadian price has remained constant for more than five years, thanks to regulation by the Patented Medicine Price Review Board, which has strict control over the prices pharmaceutical companies can charge for their products. In Canada, the auto-injectors can be claimed under most provincial drug benefit programs.

Mylan plans to double the number of patients eligible for its assistance program, which allows those who lack adequate incomes and insurance coverage to obtain an EpiPen for free. It will also offer a savings card to cover up to $300 of the cost of a two-pack, a boost from the $100 card it previously offered.

“We recognize the significant burden on patients from continued, rising insurance premiums and being forced increasingly to pay the full list price for medicines at the pharmacy counter,” Mylan CEO Heather Bresch said in a press release. “Patients deserve increased price transparency and affordable care, particularly as the system shifts significant costs to them.”

Despite Mylan’s announcement, Nicole Smith, a Colorado-based advocate for allergy solutions, says it’s still worth it for families like hers to purchase from Canada.

“I want the price in the United States to be reflective of the true price of manufacturing that medication,” Smith said. “If Canada is selling them for $110 per EpiPen, there is no reason then that the price of a two-pack in the United States should be over $600. I’m assuming that they’re still making money on it in Canada.”

Smith, whose 20-year-old son Morgan has life-threatening allergies to nuts, sesame and fish, said she spent $225 U.S. to buy two EpiPens from Canada Drugs Online, a decision supported by her son’s allergist.

“For families that have a budget that they have to adhere to and are concerned about the pricing in the United States right now … I say, purchase it through Canada,” she said.

Tim Smith, general manager of the Canadian International Pharmacy Association, said the more than 60 pharmacies it represents which specialize in mail-order products have seen a boost in EpiPens sold to U.S customers.

He said this trend is a result of “the outrage of people who are getting ready to go back to school and are going to buy supplies for their kids and find out the price has gone up so significantly.

“They’re looking for alternate sources for the medication,” he said.

Leigh is already planning to buy from Canada again when she and her husband visit his family in the Toronto area.

“If the prices don’t get any better, which I don’t foresee,” she said, “then I would definitely go through Canada again.”


https://www.thestar.com/news/canada/2016/08/25/americans-turn-to-canada-for-cheaper-epipens.html
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on August 25, 2016, 11:57:07 PM
Hey Erik! :bye:


I see that SJP has ended her connection with Mylan.  I understand why, but it makes me very sad, since she had the potential to do a lot of good for the FA community through her association. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on August 25, 2016, 11:58:14 PM
It's been rather nice to see the general public concerned about us. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: GoingNuts on August 26, 2016, 06:16:54 AM
^  :yes:
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 26, 2016, 03:57:50 PM

WARNING -- SERIAL POSTING FOR THOSE WHO DO NOT FOLLOW ON FACEBOOK OR TWITTER



This is REALLY interesting development:


http://www.statnews.com/2016/08/25/mylan-antitrust-epipen-schools/

See links within that story to Mylan company documents and agreement between schools/Mylan!

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 26, 2016, 04:02:35 PM
Related as to history & military use of injectors:

http://timeline.com/epipen-technology-drug-industry-b28d19036dee#.lruyo9y1r
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 26, 2016, 04:08:21 PM
https://www.statnews.com/2016/08/24/epipen-mylan-bresch/

Quote
If Mylan loses too much value, it could struggle to defend itself from a future hostile takeover. But Bresch herself is well-insured: According to a recent analysis from Bloomberg, if she’s deposed in a merger, she’s in line for a $61.5 million golden parachute.

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 26, 2016, 04:17:40 PM
How the EpiPen drug price story went viral — and what may be next


https://www.statnews.com/2016/08/26/epipen-recipe-price-controversy/
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 26, 2016, 04:28:25 PM
Senator Warner (D-VA) statement:

http://www.warner.senate.gov/public/index.cfm/pressreleases?ContentRecord_id=1C8A09C7-5AE8-45AB-8739-8EB911BDC93D
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 26, 2016, 04:29:48 PM
Mylan CEO Should Resign and Take her Coupons with her

http://www.huffingtonpost.com/entry/dad-to-embattled-mylan-ceo-keep-your-coupons-resign_us_57c04083e4b0b01630de6ead
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 26, 2016, 04:33:40 PM
I feel certain it is only a matter of hours until we get wind of a class action suit on this issue . . .

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 26, 2016, 04:34:51 PM
Link to suit filed due to "forced purchase" of two, rather than being able to buy a single:

http://www.freep.com/story/news/local/michigan/2016/08/25/epipen-makers-sued-selling-pens-packs-two/89350728/
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 26, 2016, 04:44:24 PM
Well, we here at FAS have been talking about this issue for more than just a couple of weeks . . . both here in MAIN and elsewhere . . .

But here's somebody else's take on how this all got going:

http://well.blogs.nytimes.com/2016/08/25/how-parents-harnessed-the-power-of-social-media-to-challenge-epipen-prices/?_r=0
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: candyguru on August 26, 2016, 11:01:12 PM
Hey Erik! :bye:


Hi Macabre! :)
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hedgehog on August 27, 2016, 07:35:57 AM
I think this quote from the CEO bears repeating.
“Had we reduced the list price, I couldn’t ensure that everyone that needs an EpiPen gets one.”

By keeping this price, they basically guarantee that NOT everyone who needs one will get one.  How on earth does this make the slightest bit of sense?
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hedgehog on August 27, 2016, 08:09:54 AM
A friend posted this on Facebook.  Glad they found another option, but mad as hell that it's necessary.  And frustrated that is only suitable for professionals.

http://kuow.org/post/king-countys-incredibly-cheap-answer-epipen
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on August 27, 2016, 10:06:51 AM
Nurses and pharmacists (here, anyway) can train patients on how to use a syringe to administer medications.  The only problem is that drawing a syringe during a reaction takes precision and fine motor skills, two things people having a reaction may not have by that point.  Cheap, yes.  Excellent option for first responder professionals, yes.  Suitable for parents and caregivers of those with allergies, possibly.  Suitable for self-injection, unlikely. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hedgehog on August 27, 2016, 01:25:57 PM
I don't know whether to laugh, cry, or cuss over this cartoon.

(http://i2.photobucket.com/albums/y25/daigledee/C634BAB5-39C5-48B1-BBD3-3905F3B052B7_zpso8ytvci5.jpg)
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: CMdeux on August 27, 2016, 02:47:25 PM
Nurses and pharmacists (here, anyway) can train patients on how to use a syringe to administer medications.  The only problem is that drawing a syringe during a reaction takes precision and fine motor skills, two things people having a reaction may not have by that point.  Cheap, yes.  Excellent option for first responder professionals, yes.  Suitable for parents and caregivers of those with allergies, possibly.  Suitable for self-injection, unlikely.

 :yes:  This.


I'll also add that it's not necessarily suitable for group care settings of any kind, either. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on August 27, 2016, 09:58:02 PM

CEO of Price-Gouging Drug Company Could Have Picked a Better Binder to Pose Beside

http://nymag.com/daily/intelligencer/2016/08/ceo-of-price-gouging-drug-company-poses-with-wrong-binder.html
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: eragon on August 28, 2016, 06:26:06 PM
 Have been following this story, very shocking the prices and choices that parents are having to make.

how can one auto injector work for all anyway? From a medical point of view it cant stand. England has the choice of 3 auto injectors, emerade, jext and epi pen.
We currently have emerade as its the only one with a full adult dose and has the advantage of 5 second delivery.  We have used both epi and jext in the past.  Needle length is an issue as well, which is why some idea for different types of auto injector have been refused in UK. Hopefully we will have more choice in time.

We have only paid for our sons auto injectors since he was 18. £8.20  per prescription, all free on nhs from age 2. Our main issue was getting them prescribed in the first place! occasionally we have had shortages, or been given some with short dates on. No one has questioned our need for them with our sons history, and so far we have been lucky to get more than one set in place for school and home. Our GP gave us 2 extra for our long haul flight to USA many years ago without hesitation.

I have been as vocal as possible about this on twitter as I see mylan as being morally corrupt and the idea that parents are faced with living without a vital safety net for their children.     Globally I think other parents in the allergy community should also be as vocal as possible and try to keep some pressure on getting a decent change for american parents and adults who live with life threatening food allergies.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hezzier on August 29, 2016, 08:40:06 AM
http://www.fox4news.com/business/196851503-story

Mylan to make a generic epi pen...hmmm? 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on August 29, 2016, 09:53:56 AM
Epigate pierced my insular academic fog.  Had a thing or two to say about it best laid out to the cool heads here even if it unintentionally dog whistles the fringe elsewhere.

Mylan direct and indirect financial support to FARE.  In a monopolistic market failure with no forthcoming transparency, this is not a good thing.  I've read elsewhere folks reading 990s, and FARE's faceless declaration of no more than 5% of budget contribution by Mylan.  Here's the thing: management needs to report faithful material statements including non-financial values.  And whether the audit is internal or external, practices and motivation or influence are still forefront ethical considerations.

FARE has itself in a pickle.  There's no way they are not aware.  I know, I've said so to them directly.  As of now they are in a years long public partnership with Mylan, who by their own declaration are direct financial contributors as well as the dominant corporate sponsor of many events, webinars, and programs that FARE has championed to schools for stock epinephrine.  The corporate cookie jar FARE has its hands in is Aimmune, patented oral immunotherapy.

My prediction now the Grassley is on the move that they will get hit with an antitrust, or if they've soaked up enough Medicare dollars and manipulated the market, a possible FCA complaint if they have a whistle blower along the way.  Or SEC oversight if they've manipulated sales in a way that affects stock price.  I can't even contemplate the likelihood of market entry barriers for competing autoinjectors.  My head will go explody.  Let's just chalk that one up to a screwed up system rather than cutthroat tactics.

Bottom line is FARE needs to align its public face with what it really is these days.  If I were them I'd break up with Mylan and only see it occasionally.  Sell off the Aimmune stock completely, deal with whatever tax situation that puts them in, and move it forward.

I am hopeful this will galvanize the market for competitors, and groom a more responsive FDA to meaningfully engage with manufacturers who already show successful products in other countries (Jext, Emerade, etc.). Oh, and someone buy the license to Twinject to bring it back.  For heaven's sake it's already approved for the US market.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: becca on August 29, 2016, 10:33:20 AM
[url]http://www.fox4news.com/business/196851503-story[/url]

Mylan to make a generic epi pen...hmmm? 


Imagine that!?  After all these years, they can produce a generic in a matter of weeks.  Amazing.   :disappointed:
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: CMdeux on August 29, 2016, 10:54:08 AM
To add to the insightful guest post above ( :bye:  )

I'd add that one thing that I suspect is that the patent renewal which occurred after the "redesign" was probably rubber-stamped-- and not examined too carefully to see whether it OUGHT to retain that patent protection.... much less new protections on that basis. 

I don't know-- haven't looked.  But it definitely occurred to me and my DH.  That might have been no accident, that 'redesign' that did bugger all to help people actually carry or use the device.  Basically making it 'anti-roll' was about the ONLY improvement at all, there were several 'features' that actually make it worse--and the mechanism is utterly unchanged.

What I don't know is when the original patent protection was set to expire (before then).  My hypothesis is that it was sometime between 2010 and 2015.   



Thanks, also to Eragon and other other non-US members who have pointed out just HOW awful this is compared with other countries.  Morally bankrupt is about the only way that I can think about this industry and what it does to the US population that pays so much for it's R&D budgets to begin with.  It's outrageous.  To a point that leaves me frankly speechless. 

This technology cost the pharmaceutical companies that have held the patent almost nothing to develop.  To MONETIZE, sure-- they had to go through the FDA for that, so yeah, lawyer-fun-times.  That cost, those applications. 

But the device itself was already paid for and WELL-developed for use with atropine.  By the military-- er, or the research that supports innovations in the military, that is.    The armed forces and space program both work this way-- when technology is not considered tactically advantageous to keep classified, then it becomes fair game for intellectual property transfer... and so it was with pre-determined dosing, autoinjection devices. 

Narcan and Epinephrine were pretty obvious candidates, since dosing is reasonably standard "per person" in emergent situations. 

All of that adds up to what SHOULD have been a robust market all along, with respect to generic devices.  Blame our patent protections for pharmaceuticals.   :dunce: 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: rebekahc on August 29, 2016, 12:51:04 PM
I wonder if it would be possible (for sure it would be cost-effective in the long run) to order a vial of epi and make your own ana-kit type setup except with an autoinjector.  Something like this:
http://www.unilife.com/product-platforms/auto-injectors/lisa-auto-injector
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on August 29, 2016, 01:03:49 PM
Interesting link, Rebekah! I like the idea of reusability and less waste, but not super keen on how it relies on electronics, which probably means battery life will be a concern. Still, a very innovative device.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: CMdeux on August 29, 2016, 02:59:33 PM
I wonder if it would be possible (for sure it would be cost-effective in the long run) to order a vial of epi and make your own ana-kit type setup except with an autoinjector.  Something like this:
[url]http://www.unilife.com/product-platforms/auto-injectors/lisa-auto-injector[/url]


The problem with this--- and this is the precise problem with vials of epinephrine-- is that epinephrine is stable for literally only a few HOURS when drawn into a syringe under exposure to air. 


Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hezzier on August 29, 2016, 07:28:14 PM
http://chicagotonight.wttw.com/2016/08/29/allergist-mom-says-mylan-should-lower-cost-epipen
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: aggiedog on August 29, 2016, 07:51:22 PM
I haven't posted here in Main forever, but this whole epi-pen thing makes me crazy.  Aside from the fact that the price increase is, as CM says, morally bankrupt, it amazes me that they 1.) increase the price 3 fold or more, 2.) magically create a generic over night, that is 3.) still more expensive than the branded epi started out at.  It's like bait and switch - we'll make it so expensive that when we "discount" it, they'll never realize they're still paying thru the nose!

I'm not buying it.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on August 29, 2016, 08:05:49 PM
I just miss the AuviQ so, so much.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Name on August 29, 2016, 08:17:37 PM
What worries me is the dearth of competition in the US market--for reasons other than obvious choice.  Should there be a fact pattern that points to significant market manipulation that bled over to accounting gymnastics inflating revenues artificially, then they are in much deeper doo-doo then they could ever imagine.  Worse, if there is evidence of any heavy exercise of stock that might indicate insider trading coordinated with market manipulation. 

With this monopolistic production, no matter if it were the worst of the worst corruption, that product must continue to be manufactured because there are no comparable substitutions given schools have been groomed to demand branded EpiPens to use on students.  It's what they will be trained to.

And, while we may or may not find out exactly how much total support or sponsorship FARE has from Mylan, neither will we know in an actionable timeframe which and / or how many executives from FARE over the years held Dey or Mylan stock.  Certainly we know past FARE chief executive officers have hailed previous executive positions in Dey.

Mylan producing its own generic is not competition, nor does it address business practices.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Name on August 29, 2016, 08:21:43 PM
I wonder if it would be possible (for sure it would be cost-effective in the long run) to order a vial of epi and make your own ana-kit type setup except with an autoinjector.

The problem with this--- and this is the precise problem with vials of epinephrine-- is that epinephrine is stable for literally only a few HOURS when drawn into a syringe under exposure to air.

Wow.  That is a sobering fact I don't think many (self included) consider with vials.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: YouKnowWho on August 29, 2016, 08:32:31 PM
But the vials are so doable - that is what it says on the internet.  Won't say I haven't considered them for home but yeah, not so much.  The link I read is that we just need to keep it all in an Altoids tin and it will be fine  ~)

I roll my eyes but friends are having to consider this method due to high cost.  Not that they want to but the price is ridiculous.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on August 29, 2016, 09:25:25 PM
It's good to see you, name!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on August 29, 2016, 09:32:13 PM
Here's the deal--I do not consider vials at all. Not at all. I have an ER doc friend in a small west Texas town who said he wants to begin a training campaign with them (YKW I think you got caught in his reverie on a post of mine on FB).

Vials are only useful in a medical setting. I won't even say home. I've given epi two DS once at home, once at ballet (and he has gotten it at school twice and at dance camp once). I've given it to myself once at home and once in the parking lot of a hospital.  So we are not strangers to giving epi, right? Of the four times I have given it, I do not know of one where I would have been able to have the composure to deal with a vial. And certainly not on myself during my last reaction at home alone. I had to have dh walk me through giving myself an Epi. I felt a bit spacey and was not so clear headed.

I am so grateful this thing has taken off on FB. But several friends have suggested the vial and no way am I going to do that.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on August 29, 2016, 11:48:21 PM
The pitchforks and torches are out in force on Mylan's Facebook page.  What I hope cooler discussion promotes on this medium is a longer term approach to the broader concern of two items (1) competition leading to robust choices in autoinjectors in the US market that reflect successful products offered for years in the UK, Sweden; (2) FARE must purge its pharmaceutical conflicts of interest by selling off its vested interest by way of Aimmune stock, and invite external, independent, and fully transparent audit of its direct and indirect financial relationship with Mylan.

SJP broke up with Mylan!  Carrie knows what's up!

We are not a herd to be farmed, managed, then fed to the makers of medicines.  It's too much to expect of members whose reasonable expectations of annual dues contributes to their true best interest.  Last word is a lowered EpiPen price is not a final answer, only a short term solution for some.  We need our independence back in advocacy free of the market forces of pharm investors, and autoinjector choices as well as technological ADVANCES.  Patents in theory are to serve the public and reward innovation.  Limited 'deadweight loss' is granted by the government to allow the public to trust a branded good.  This has mutated into market dominance stifling innovation and entry by competitors in life or death stakes.

Cheers, ladies.  Keep on rockin'. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: my3guys on September 01, 2016, 12:12:36 PM
WOW!

http://www.huffingtonpost.com/entry/father-to-epipen-ceo-my-daughters-will-be-nothing_us_57c48b04e4b024fca58c9367?
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on September 01, 2016, 12:20:10 PM
I cannot find an official page for Mylan at Facebook?

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 01, 2016, 12:40:20 PM
Clerical error.  Should have been posts about Mylan at FARE's Facebook page.  I cannot edit as a guest.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on September 01, 2016, 01:28:45 PM
No problem.  THanks!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on September 01, 2016, 01:29:07 PM
FAACT survey as to Epipen experience:

http://www.surveymonkey.com/r/FAACTEpiAnswers



FAACT = The Food Allergy & Anaphylaxis Connection Team, FAACT
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hedgehog on September 01, 2016, 02:53:56 PM
WOW!

[url]http://www.huffingtonpost.com/entry/father-to-epipen-ceo-my-daughters-will-be-nothing_us_57c48b04e4b024fca58c9367?[/url]


After reading this, I just posted that on FB. Very moving.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: becca on September 01, 2016, 06:59:51 PM
I saw that today too, HH.  Very moving, and so true, for my dd too. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hedgehog on September 01, 2016, 07:20:22 PM
You know, now that I think about my DD in this context.  She is a business major, and incredible at it.  She understands how this stuff works far better than I ever could.  And she certainly hopes to make $$$ at some point. But, she is also very caring, and truly wants to make the world a better place.  I don't want to give too much info, but her internship this summer was at the charitable division of a company that is really about financial services.  And she loved it.  The perfect blend for her...the business of trying to make money, working with stocks, commodities, and other assets. , but the good effect of that money going to good causes. I hope she does not change.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 02, 2016, 02:12:52 PM
In the interest of public access to critical information here is a partial link to Mylan's citizen petition to block a generic from market.  Their arguement goes something like, "Schools are trained to use branded EpiPens so this generic will dangerous because it's slightly different to use."

.pharmamedtechbi.com/~/media/Supporting%20Documents/The%20Pink%20Sheet%20DAILY/2015/January/Citizen_Petition_Mylan_Specialty_epinephrine%20autoinjector%20ANDA.pdf
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Stinky10 on September 02, 2016, 10:26:14 PM
I can't open that....  :(
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Ciel on September 05, 2016, 10:49:12 AM
One of my favourite podcasts, Sawbones, did an episode about the EpiPen. It was posted 31/08/2016, currently still at the top of the page. It's about the history of EpiPen/Epinephrine and Anaphylaxis, and talks about the current price issue for the last 15 min. She states that the annual profit the EpiPen brings in for Mylan is 1.1 billion dollars! She also says that 85% of the research & development costs are covered by taxes. (she doesn't state the sources in the podcast).

From Allergic Living:

Senators Press Mylan for Answers on EpiPen Price Hikes

Inside the EpiPen Price Backlash


I am so relieved to live in Canada where we have laws to prevent this sort of unconscionable gouging.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: GoingNuts on September 06, 2016, 04:01:56 PM
New York State's Attorney General has launched an investigation into Mylan:

http://blog.timesunion.com/capitol/archives/267036/schneiderman-announces-probe-into-epipen-price-hike/
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on September 07, 2016, 07:10:41 AM
In the interest of public access to critical information here is a partial link to Mylan's citizen petition to block a generic from market.  Their arguement goes something like, "Schools are trained to use branded EpiPens so this generic will dangerous because it's slightly different to use."

[url]http://pharmamedtechbi.com/~/media/Supporting%20Documents/The%20Pink%20Sheet%20DAILY/2015/January/Citizen_Petition_Mylan_Specialty_epinephrine%20autoinjector%20ANDA.pdf[/url]
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hezzier on September 07, 2016, 07:55:46 AM
DD came home from school with a picture of a sign posted somewhere at school talking about the increased price of epi pens and then gave the website address for the coupon.  I was on DS's school website and information about the coupon is also there. 

DD said a couple friends were talking about it during study hall because they have an english class assignment about it.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 07, 2016, 09:40:51 AM
A good breakdown on antitrust, purchasing contracts, and schools.  Link must be copied and pasted in browser with complete address.

Mylan may have violated antitrust law in its EpiPen sales to schools, legal experts say

statnews.com/2016/08/25/mylan-antitrust-epipen-schools/

law.com/sites/almstaff/2016/09/06/ny-attorney-general-launches-antitrust-investigation-into-epipen-in-connection-with-school-sales-contracts/

Quote
Sen. Amy Klobuchar, D-Minnesota, last month called for a Federal Trade Commission investigation into whether Mylan engaged in any anti-competitive acts connected with the series of price increases that have brought attention to the EpiPen. In a letter to the FTC, she said the commission “should investigate whether Mylan Pharmaceuticals engaged in activity, such as using incentives or exclusionary contracts with insurers, distributors or pharmacies, to deny an alternative product access to the market.”

An FTC spokeswoman said in August it would “carefully consider” Klobuchar’s letter. A spokesman said Tuesday the FTC could not comment on investigations by other agencies, nor on whether the FTC is conducting an investigation. Klobuchar, along with Sen. Richard Blumenthal, D-Connecticut, continued to pressure the FTC on Tuesday, urging the commission to issue a subpoena to Mylan to determine how the company gained its “monopoly position.”

statnews.com/pharmalot/2016/09/02/scott-stringer-blasts-mylan-board/

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 07, 2016, 10:25:11 AM
Competitors we can watch.  Market entry is an important part of the long term solution for prevention of monopoly, choice.

@WindGapMedical
@AdrenaCard

I am aware Sanofi turned Auvi-q back over to kaleo pharm and their Evzio is going gangbusters.  That is precisely why I did not include them.  Evzio is their focus.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on September 08, 2016, 06:05:07 AM
Thanks, name!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on September 08, 2016, 06:08:39 AM
Well, FARE is no longer accepting donations from pharmaceutical companies.

This is the right thing to do. As a professional fundraiser, I know it's also difficult to say no to 6% of your revenue (especially mid-fiscal year) knowing you have to find it elsewhere. 

But it's the right thing to do.

http://www.foodallergy.org/press-room/fare-statements/090716#.V9FFMYY8KnP
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: GoingNuts on September 08, 2016, 06:27:12 AM
^^Was just coming on to post the same thing.  :thumbsup:
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 08, 2016, 03:37:48 PM
video.foxbusiness.com/v/5116033769001/senate-panel-to-probe-epipen-pricing/?#sp=show-clips
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on September 09, 2016, 10:50:35 PM
http://www.grassley.senate.gov/sites/default/files/constituents/Mylan%20Response%20to%20Sen%20Grassley%209%208%2016%20(002).pdf
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hezzier on September 10, 2016, 11:13:02 AM
This is from the last article posted...

Quote
In the U.S. alone, Mylan sells 21 billion doses annually of 635 products,
at an average selling price of approximately $0.25 per dose across all of our specialty and generic
products, including the EpiPen Auto-Injector.

My first thought to this is then WHY are people paying $600 for a 2 pack?

Have to keep reading the article...
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on September 10, 2016, 01:07:22 PM
EpiPens made the Lightning Round of Wait, Wait...Don't Tell Me this week.

That's like the Big Time for me!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: GoingNuts on September 10, 2016, 02:06:44 PM
^  :rofl:
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: momma2boys on September 10, 2016, 03:11:35 PM
I saw a 2 pack in our waiting bin as cash, waiting for someone's new insurance card...$753.00!!!!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Macabre on September 10, 2016, 03:25:37 PM
OMG. Wow.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Puddles on September 19, 2016, 07:51:58 AM
Anyone else catch the Mylan dis on the Emmy's?

The kids from "Stranger Things" we're giving out pb& jelly sandwiches and Kimmel said something about people with food allergies....sorry we could only afford one epi-pen.

I know not everyone has my sense of humour, but I thought it was funny.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: BensMom on September 19, 2016, 09:37:31 AM
I saw that, but was also concerned that they were handing out pb sandwiches to every single person there. Hope no one was severely allergic. I was watching to see if anyone was making a run for the doors!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Puddles on September 19, 2016, 10:03:55 AM
I saw that, but was also concerned that they were handing out pb sandwiches to every single person there. Hope no one was severely allergic. I was watching to see if anyone was making a run for the doors!

I was looking for that too. And I had only noticed one child in the audience, sitting in someone's lap. Not that adult allergies are not important, but I would have been more worried if this were done in an auditorium full of kids.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 20, 2016, 02:01:44 PM
The Epigate Epilogue

nytimes.com/2016/09/16/business/epipen-maker-mylan-preventative-drug-campaign.html

nytimes.com/2016/09/16/business/what-happens-if-epipens-get-the-preventive-label.html
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on September 20, 2016, 09:07:57 PM
clickable link

http://www.nytimes.com/2016/09/16/business/epipen-maker-mylan-preventative-drug-campaign.html?_r=0
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hedgehog on September 21, 2016, 06:50:57 AM
Wow.  It would be great for people to not have a copay for their epipens.  It would certainly save lives.  But it is a deal with the devil.  They could charge whatever they want, most people would be unaware, and we all end up paying for it.  And Mylan continues to make an obscene amount of money from it, and it becomes another way for Mylan and other pharmaceuticals to line their pockets.  Wow.  Usually I think when lives are at stake, that takes priority over moral high ground.  But I just cannot get behind this.  There is too much damage that could be done.  And part of the fallout could endanger lives of people who need the next drug they try this tactic with, if it succeeds.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 21, 2016, 09:51:38 AM
Nothing we here have not known for YEARS (looking at you USA Today) but it is sort of surreal to see major publications 'uncover' unethical NSBA influence on schools. 

.usatoday.com/story/news/politics/2016/09/20/family-matters-epipens-had-help-getting-schools-manchin-bresch/90435218/
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: BensMom on September 21, 2016, 11:49:51 AM
Mylan CEO will be testifying before Congress today at 2pm. I'm going to try to watch or listen on cspan.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: BensMom on September 21, 2016, 03:37:58 PM
Just watching bits of the hearing and she seems shockingly unprepared. She knows they've invested a billion dollars over 8 years, but doesn't know how much they've made.

"The system wasn't intended for people to pay the wholesale acquisition cost."

Instead of giving everyone a discount card and co-pay card and giving free epipens to schools, why don't they just lower the price to a reasonable price so everyone can just buy them?
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: BensMom on September 21, 2016, 03:54:32 PM
I don't know if this woman is dense or is just trying to deflect. She's being asked about schools that got a discounted price and she keeps talking about the free epis that they gave to schools. Tammy Duckworth is going after her. Schools can get 4 free epis. If they want to buy more, they can get them at a "discounted" price of $110 (which is the old price) and to get that they have to sign a form that says they won't buy any autoinjectors from any competing company.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: GoingNuts on September 21, 2016, 03:56:01 PM
We just stumbled on it here in Ireland!  Was just about to fall asleep, heard Tammy Duckwort holding
Her feet to the fire. 👍
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: lakeswimr on September 21, 2016, 05:22:38 PM
Once there is any other option we wont' be giving them our business again. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 21, 2016, 06:33:49 PM
There are plenty of fingerprints all over the fabrication of this monopoly.  Mylan alone is not solely responsible: to ignore that critical component to market manipulation invites the same collusion in the future.  The blame needs to be portioned out accordingly.

Bresch had mommy and daddy in government and the NSBA.  Mylan funds every last allergy nonprofit out there in "patient education partnerships" with celeb spokespersons.  The FDA actually entertained a so-called citizen's petition from Mylan to block Teva's generic entry into the market.

The ugly fact is influence eased the path to total market control.  Greed is but one ingredient, and I am fearful of a short-memory public that will overlook the supporting cast scuttling away that facilitated serving us up on a platter to Mylan.

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 21, 2016, 07:19:49 PM
Duckworth questioning Bresch over EpiPen4Schools program implementation requiring exclusion of competing epinephrine autoinjectors to purchase more at a 'discounted' price, and the role of Bresch's mother as an NSBA executive promoting the program without disclosing her relationship to Bresch and Mylan.  You'll have to copy and paste.

youtu.be/JhVQyUrafqE
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on September 21, 2016, 09:32:29 PM
I don't like where this whole 'preventative drug' thing is headed.  That's just UGLY.

Could there ever be some sort of fallout from this making EpiPens themselves being pulled from the market in America (if, say, Mylan's rights to produce it are revoked)?  Or tarnishing the brand for us in other countries that have no other option?  EpiPen here is made by another company, yes, but could this ugly investigation somehow affect the EpiPen brand elsewhere?  (Because it kind of makes me nervous.  There are no generics or alternatives here.  At all.)
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Puddles on September 22, 2016, 07:19:05 AM
I don't like where this whole 'preventative drug' thing is headed.  That's just UGLY.

Could there ever be some sort of fallout from this making EpiPens themselves being pulled from the market in America (if, say, Mylan's rights to produce it are revoked)?  Or tarnishing the brand for us in other countries that have no other option?  EpiPen here is made by another company, yes, but could this ugly investigation somehow affect the EpiPen brand elsewhere?  (Because it kind of makes me nervous.  There are no generics or alternatives here.  At all.)

Sold by another company, but I think they are made in US by Mylan. (Bresch tried to throw us under the bus saying American's were subsidizing epi's for the rest of the world.)

I am curious though, anyone who is a part of other on-line forums, especially any funded by Mylan, has cost of epi-pen been a topic there? Only since the topic is trending, or long before, like here?
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: BensMom on September 22, 2016, 09:08:15 AM
Listening to a bit more of the testimony. She was either just woefully unprepared or just didn't want to answer simple questions, such as how much did Mylan spend on patient assistance programs. How much did Mylan spend on marketing. She got scolded for coming into a hearing, knowing exactly what it was about, and not having these figures available.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on September 22, 2016, 11:04:17 AM
Didn't get to see it -- hoping I can find online or at CSpan or they rerun.

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: BensMom on September 22, 2016, 11:11:01 AM
Here you go....
https://oversight.house.gov/hearing/reviewing-rising-price-epipens-2/
 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: my3guys on September 22, 2016, 12:26:25 PM
And...the CEOs mother was involved with getting Epipens in schools.

http://www.usatoday.com/story/news/politics/2016/09/20/family-matters-epipens-had-help-getting-schools-manchin-bresch/90435218/
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on September 22, 2016, 01:32:05 PM
Thanks!

I also found these links at youtube

[b][color=red]![/color][/b] No longer available

and


[b][color=red]![/color][/b] No longer available
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 22, 2016, 05:43:15 PM
And...the CEOs mother was involved with getting Epipens in schools.

.usatoday.com/story/news/politics/2016/09/20/family-matters-epipens-had-help-getting-schools-manchin-bresch/90435218/

Under the auspices of a leadership position at the NSBA.  Again, nothing we here did not call it for what it was years ago.  I know someone queried if this awareness existed on other forums, and what I'm guessing is some sort of (legitimate) cursory evaluation of critique vs. obeisance based on Mylan funding. 

I would guess not, but not based on financial influence.  Interwebz, please forgive what will undoubtedly sound like conceit or hubris, but given the professional array here I would not expect many other such watering holes of SOAK + scholarship + communication/relationships capable of producing the required analysis.  And if you think about this for the long term crew we only accrue more education and experience.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 22, 2016, 05:56:10 PM
I don't like where this whole 'preventative drug' thing is headed.  That's just UGLY.

Could there ever be some sort of fallout from this making EpiPens themselves being pulled from the market in America (if, say, Mylan's rights to produce it are revoked)?  Or tarnishing the brand for us in other countries that have no other option?  EpiPen here is made by another company, yes, but could this ugly investigation somehow affect the EpiPen brand elsewhere?  (Because it kind of makes me nervous.  There are no generics or alternatives here.  At all.)

I don't think so, space.  The worst I anticipate for Mylan is predicated on antitrust and accounting or market irregularities that would result in fines and increased oversight.  The FDA is certainly part of this equation as it is the sole entity that can approve competitors.  Likely some personnel will be be removed as a result to appease the public and some products stuck in the pipeline may be prioritized or fast-tracked.  Administration and government oversight is my gig, not pharm per se, therefore I leave that to the appropriate subject-matter experts.

Mylan should be barred from filing citizen petitions against autoinjector competitors, particularly generics, based on its monopoly status.  They will be more heavily regulated, but not run out of business.  Sunshine is the best disinfectant, as the saying goes.   I'm more curious about what will happen to their patent claims in the next five years.  If my understanding is correct they have very little novel additions to the original design other than what really amounts to ancillary functions, such as needle cover.  Delivery, needle length, mechanics, storage of liquid, and shelf life are relatively unchanged from the original military innovation for field injection by laypersons under duress.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 22, 2016, 06:02:27 PM
This is a separate observation.  Innovation, marketing, and design will soon have to track the flow of first-wave children now in adolescence and adulthood carrying epinephrine injectors.  Sure, schools are armpit-deep in dealing with students with food allergies and at the time the EpiPen4Schools program was great for market dominance.  Things have changed.  What's the plan now? 

Oh, and I'd also like to see a statement from any person serving on a board in an advisory position or executive position on what the individual's holdings are in related stocks to Aimmune or Mylan.   Any material statement that would be consistent with AICPA ethics.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 22, 2016, 09:23:18 PM
W. Va. Attorney General launches investigation into Mylan for antitrust and fraud.

"Morrisey is investigating if Mylan was issuing Medicaid rebates for EpiPens at "non-innovator" levels, which are typically used for generic drugs, rather than at "innovator" levels, which are used for name-brand drugs. Since EpiPen is a name-brand drug, the company could face Medicaid fraud action if they were paying lower level "non-innovator" rebates, according to the court documents."

"I have a statutory responsibility to investigate any potential antitrust violation," Morrisey said in a statement today. "Consumers lose when competition doesn't flourish. My office owes it to consumers to be their watchdog and turn over every rock to ensure fair play."

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: eragon on September 23, 2016, 08:03:43 AM
I watched it live (was very late for me in UK)  and found it gripping viewing!

I dont believe the statements that EU or UK are part of the reason that Mylan are charging so much, total red herring imo.

T here is competition in EU   and in England as we have choice of 3 auto injectors and so they will be receiving  a competitive and more normal rate for their product.  The   NICE <National Institute of Clinical Excellence > within the NHS negotiate the cost. 
The NHS has a long history of taking their time on getting new medicines approved etc, but we still have choice of three auto injectors and emerade is a new recent addition. So have no clear idea why the FDA in US have not approved any other  choice. So something isnt right ( certainly looks a bit fishy if you ask me!)
On the other hand mylan have been concerned that another product may be on horizon otherwise they would not have demanded that school sign contracts that bind them to the single choice of epi pen. 



I have been also wondering about dose choices of epi pen, as in England the only current higher adult dose for auto injector is emerade from what i recently gather from my son's GP.  So what are the current dose choices in US?  My son has 2 higher dose as last anaphylaxis required 2 and his reaction was very speedy compared to previous times. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on September 23, 2016, 12:29:28 PM
The current dose options in North America are 0.15 and 0.30. The standard is to carry two autoinjectors in case an additional dose is required.

I wonder why some of the European and Asian autoinjectors haven't made their appearance here yet too. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Ciel on September 26, 2016, 03:54:58 PM
I'm not sure if this belongs in this thread but wanted to mention somewhere.

I got a new EpiPen today, I didn't bother with a prescription and paid $154.23 total for a single EpiPen (BTC). I've never seen a two-pack here in Canada (ON).

Basically you either pay the cost of the EpiPen + the dispensing fee (with a prescription) or pay the cost of the EpiPen + 13% tax (BTC). The pharmacist told me she thought the base cost of the EpiPen was slightly less with a prescription but she wasn't sure. That sounds a bit questionable to me, but I don't know. The base cost was $136.49 CAD. So it is a little bit cheaper to have a prescription if paying out of pocket. I don't have drug coverage, but if you do, obviously it is much cheaper that way. Both should be the same concerning income taxes.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: CMdeux on September 27, 2016, 07:28:19 PM
There are plenty of fingerprints all over the fabrication of this monopoly.  Mylan alone is not solely responsible: to ignore that critical component to market manipulation invites the same collusion in the future.  The blame needs to be portioned out accordingly.

Bresch had mommy and daddy in government and the NSBA.  Mylan funds every last allergy nonprofit out there in "patient education partnerships" with celeb spokespersons.  The FDA actually entertained a so-called citizen's petition from Mylan to block Teva's generic entry into the market.

The ugly fact is influence eased the path to total market control.  Greed is but one ingredient, and I am fearful of a short-memory public that will overlook the supporting cast scuttling away that facilitated serving us up on a platter to Mylan.


THIS post....



is a thing of savage beauty.

 :yes:
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: becca on September 27, 2016, 10:42:55 PM
About expiration...cross posted.

https://www.washingtonpost.com/news/wonk/wp/2016/09/27/why-epipens-expire-so-quickly/?postshare=1991474999508059&tid=ss_fb
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on September 28, 2016, 10:47:12 PM
AYFKM.  Not enough of a lesson learned with Mylan?  Icarus much?  I'm so incredibly glad there's NO RELATIONSHIP between the advisory board and Aimmune.  I'm sure 'Dan' rode the Tardis in from another dimension with no Aimmune overlap whatsoever.  For the record, I have zippo to do with that wack OIT101 group riding my posts.   

Good to know you're pleased, James. 

Quote
Until resigning to become Chief Medical Officer of Aimmune, Dr. Adelman was a member of the prestigious Research Advisory Board of Food Allergy Research & Education (FARE), the world’s largest private funder of food allergy research. For several years, he was actively involved in reviewing FARE’s research funding and helped to shape the organization’s overall research strategy.

“We’re deeply grateful for the contributions Dan has made as a member of our Research Advisory Board, and we’re pleased to see him join Aimmune,” said James R. Baker, Jr., M.D., FARE CEO and Chief Medical Officer. “Dan’s leadership and clinical expertise will be great assets as Aimmune continues to progress toward what would be the first FDA-approved oral immunotherapy for food allergies. This treatment could make a great impact on the lives of millions of people at risk from peanut allergy.”

For timeline purposes this was released right before Epigate really blew up.  Dated Jun 21, 2016.

businesswire.com/news/home/20160621005527/en/Aimmune-Therapeutics-Appoints-Daniel-Adelman-M.D.-Chief
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on October 01, 2016, 07:00:38 PM
Pretty interesting.

http://www.mercurynews.com/2016/10/01/epipen-outrage-silicon-valley-engineers-figure-true-cost-to-make-lifesaving-auto-injector-about-10/
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on October 03, 2016, 09:41:23 AM
As Ciel did, I am reporting the cost of my EpiPen refill in BC, Canada: $0 with third party medical insurance.  (It is a VERY good policy. No fee except for brand name drugs.)

Without insurance coverage, it would have been $102.64 with a prescription or $95.65 over the counter (no $6.99 dispensing fee.) This was about the same price I paid for a refill in March in Alberta.

My expiration date was January 2017, however, which made me a little upset (4 months, seriously?) but with no cost refills it doesn't really matter to me one way or the other. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Penny on October 05, 2016, 08:24:36 PM
New Zealand - my Epipen was about US $120 six months ago.  Epipen isn't subsidized by Pharmac - our national healthcare meds program....so I paid the full OTC price.  Epinephrine and syringes are subsidized for about US $3.  It's my understanding that low income children are provided Epipens at no cost. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: name on October 06, 2016, 07:06:56 PM
CMS sends notice to Mylan, plus mention of potential False Claims Act prosecution.  Notwithstanding the multiple state antitrust investigations of Mylan, this isn't anything different than mentioned upthread.  What I'd be worried about now is how it resolves.  If you look at Bear Stearns, Lehman, Madoff, you'll see a pattern of collapse rather than recovery because things have gone so far it's almost impossible to recover money spent.  I'm sure Bresch can walk away with a golden parachute.  Remember, daddy's a US Senator and mom was high level executive in the National School Boards Association.   We can't wish for collapse because we have none of the autoinjector choices available in more diverse markets (like Jext, Emerade).

The problem as I see it is the complexity FARE should have not introduced by blind support to Mylan pushing for the epinephrine school legislation.  The legislation itself is great: the implementation lacked some basic planning and foresight.  At the very least those non-compete contracts should have been scrutinized within the context of a near monopoly looming.  While no one can forecast this is what is required of basic policy planning.  If FARE does not soon resolve its conflict of interest with another for-profit pharmaceutical, I may consider writing to request a congressional investigation.  Good faith doesn't negate destabilizing the market, or manipulating it even if there isn't a high level of intent in the early stages.

Federal government: Mylan has been overcharging for EpiPens

seattletimes.com/business/federal-government-mylan-has-been-overcharging-for-epipens/
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hezzier on October 26, 2016, 07:37:40 AM
Not sure if this is where we want this...but Auvi-Q might be back sooner rather than later

https://robynobrien.com/auvi-q-auto-injector-returns-life-threatening-allergic-reactions/
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Puddles on October 26, 2016, 08:10:34 AM
As Ciel did, I am reporting the cost of my EpiPen refill in BC, Canada: $0 with third party medical insurance.  (It is a VERY good policy. No fee except for brand name drugs.)

Without insurance coverage, it would have been $102.64 with a prescription or $95.65 over the counter (no $6.99 dispensing fee.) This was about the same price I paid for a refill in March in Alberta.

My expiration date was January 2017, however, which made me a little upset (4 months, seriously?) but with no cost refills it doesn't really matter to me one way or the other.

When purchased OTC, isn't tax added? There was something my doctor prescribed many years ago, and it was cheaper as a prescription because the tax was higher than the dispensing fee.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: ajasfolks2 on October 26, 2016, 01:28:40 PM
Allergic Living re: return of AuviQ

http://allergicliving.com/2016/10/26/auvi-q-makers-announce-relaunch-of-talking-auto-injector/
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on October 26, 2016, 01:40:03 PM
When purchased OTC, isn't tax added? There was something my doctor prescribed many years ago, and it was cheaper as a prescription because the tax was higher than the dispensing fee.
Possibly.  I am not sure which taxes would apply: 5% GST would be cheaper than the dispensing fee, but if you had to add the 7% PST (in BC) on top of that (making 12% total tax) the prescription would be cheaper... Still cheaper than in America though.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: Puddles on October 26, 2016, 02:09:31 PM
I'm not sure what taxes are included either. And 6.99 is the low end of dispensing fees.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: PurpleCat on October 26, 2016, 02:54:51 PM
Allergic Living re: return of AuviQ

[url]http://allergicliving.com/2016/10/26/auvi-q-makers-announce-relaunch-of-talking-auto-injector/[/url]



THIS!!!!

Makes me so very happy!  Saw it all over Facebook this morning and have been smiling all day about it.  If all goes well, DD can have those for college!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: spacecanada on November 05, 2016, 06:24:12 PM
Has there Beene muh of an update on this whole Mylan and EpiPen cost issue? Any efforts to truly lower the cost to patients? Not insurance loopholes, not discount cards, but actually lowering the full cost?

It seems to have fizzled out in the media and I don't really see and quantitative results. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: GoingNuts on April 02, 2017, 07:57:30 AM
From Medscape - Another Look at the Cost of EpiPens

(Reuters Health) - Soaring prices and out-of-pocket costs for EpiPens to treat severe allergic reactions haven’t halted a surge in the number of children and adults filling prescriptions for the devices, a U.S. study suggests.

Researchers who analyzed prescriptions filled by privately insured people found that out-of-pocket spending for EpiPens climbed 535% from 2007 to 2014. During that same period, annual EpiPen prescriptions almost tripled.

But the number of prescriptions filled by each patient barely changed. This suggests patients’ costs rose due to price increases, not because people started using more EpiPens, said lead author Dr. Kao-Ping Chua, a public health researcher at the University of Chicago.

“For EpiPen in particular, failing to fill a prescription due to cost could mean the difference between life or death when serious allergic reactions occur - this is why Mylan’s EpiPen price hikes are so ethically troublesome,” Chua said by email.

Generic drugmaker Mylan obtained the rights to sell EpiPen in 2007. Since then, Mylan has increased the list price from $94 to $609, researchers reported March 27 online in JAMA Internal Medicine.

In part due to patient outcry over rising out-of-pocket spending, Mylan released a $300 generic EpiPen in December, the researchers note.

More recently, health insurance giant Cigna dropped coverage of the branded $600 EpiPens and drugstore chain CVS started selling a generic epinephrine injector from Lineage Therapeutics, Inc. for $110.

For the study, researchers examined data on people who receive private health insurance through more than 100 employers nationwide. They looked at co-payments, co-insurance, deductibles and total out-of-pocket spending.

From 2007 to 2014, patients’ average annual out-of-pocket spending on EpiPen rose from about $34 to $75.

The proportion of patients with out-of-pocket costs of at least $100 climbed from 4% to 18% during the study period, while the share of patients with costs of at least $200 increased from 0.1% to almost 5%.

In October, Mylan agreed to pay the U.S. government $465 million after it was accused of falsely classifying the brand EpiPen as a generic medicine to reduce the size of the rebates it owed. Drugmakers pay rebates to Medicaid but they pay less money if a drug is a generic. Mylan didn’t admit wrongdoing.

Mylan avoided paying $226 million in rebates on only two formulations of EpiPen from 2012 through 2016, according to a separate study in JAMA Internal Medicine. That suggests the total amount Mylan owed the government may far exceed what the company agreed to pay in the settlement, the authors write.

“High spending on prescription drugs on the part of public payors like Medicaid means that they have less to spend on coverage for other health benefits such as doctor’s visits, hospitalizations and long-term care,” said lead study author Dr. Jing Luo of Harvard Medical School and Brigham and Women’s Hospital in Boston.

“They must either reduce covered healthcare services or reduce the number of eligible members and kick people off Medicaid,” Luo said by email.

A Mylan spokesperson declined to comment on the Medicaid study beyond a statement made at the time of the settlement (here: http://bit.ly/2dLhDCA).

In January, Mylan said that about 90% of consumers who got its brand or generic EpiPen had an out-of-pocket cost of less than $50. During the same timeframe last year, 80% of patients paid less than $50 out-of-pocket, the company said.

SOURCE: http://bit.ly/2nYjF7y and http://bit.ly/2nYc2xL

JAMA Intern Med 2017.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: nyguy on April 02, 2017, 09:27:40 AM
The problem is the US pricing system is so opaque that it's impossible to tell who actually pays what for a drug.

First off, you get a list price. Larger pharmacy benefit managers will negotiate a discount on most brands or exclude them from coverage. Then you have pharmacy benefit manager rebates. They don't tell you what these are. Depending on your plan the PBM can keep all, some, or none of the amount (in large group plans they'll give the entire amount to the company responsible for the plan). When you're trying to pay your deductible off you might pay the $250 in entirety for a thirty day supply of drug xyz even though your PBM/company only spent $125 due to the PBM rebate.

Then we have coupons and copay cards. Example: I fill 90 days of drug ABC. Price my insurer tells me is is $750 (again, not realistic), my copay for a preferred brand is just short of $75. CVS at retail automatically applies a coupon that brings it barely above $30 for my out-of-pocket. Then you have the same thing with Auvi-Q: $9,000 price for four injectors, $90 copay, PSKW rebates the $90 on behalf of Kaléo Pharma, I'm zero out of pocket.

And for totally different price scales, Lineage (Adrenaclick) and Kaléo (Auvi-Q) basically do the same thing: Adrenaclick will rebate via copay card to $10 ($110 retail minus $100 max benefit) for people who don't have insurance, Kaléo will provide Auvi-Q for $0 for people with commercial insurance who refuses to cover it or don't have commercial insurance but make less than $100K/yr via patient assistance program.

I think the biggest problem is that the Lineage Adrenaclick, Mylan EpiPen/generic EpiPen, and Auvi-Q are all not A/B rated with each other so Adrenaclick cannot be substituted for a prescription written as EpiPen, even without the "dispense as written" box being filled.. Some states permit A/B rating substitution at pharmacist discretion, but even in the states that do it 90%+ of pharmacies (under a chain) the pharmacist won't exercise that right. Even before the whole EpiPen pricing outrage my local one store pharmacy substituted Adrenaclick for an Epipen prescription at their discretion (I think it was availability to fill, not copay, but I'm not sure).

Allergies have increasingly grown in public consciousness which is why people will fill EpiPens: Nobody wants to risk the worst case scenario. At the same time PBMs have incentive to limit costs. I think the market has normalized at this point and the market will largely correct itself:

1) Anybody with medicare/medicaid will probably be covered for the generic Epi regardless.

2) People without those and without commercial insurance are likely more price conscious, and with the whole EpiPen scandal doctors will likely know and promote the Adrenaclick for a cheaper fill for these patients.

3) People on commercial insurance will likely either have EpiPen covered or at least the generic version. Generic doesn't have the same copay offer but the price is much more reasonable under copays.

4) People with permissive insurance will find Auvi-Q covered at a ridiculous price to insurer, if they don't cover it under commercial insurance Kaléo will fill for free at direct delivery. They'll capture a smaller portion of the market due to less brand awareness. (I think this strategy will bite Kaléo in the a** in the end as there's no real incentive for PBMs to continue to fill Kaléo if they will fill scrips for free if they blacklist it, but that's another topic).

/endrant, sorry for the brain dump.

Title: Epipen prescription problems!
Post by: my3guys on August 10, 2017, 12:22:29 PM
So...I went to get my kids' epipens refilled for school. Wow have things changed!

1) I'm told there's still a shortage, and the pharmacist said all the ones they get in are dated within the year now. None that he's seen last longer than a year!!!???? I picked up a generic epipen yesterday with an expiration date of APRIL. They only place orders for them when they get a prescription, and he said they don't always get them when they order them???

2) I was told that my insurance company no longer covers the name brand, so I received generic. We have Cigna. I will be calling my insurance company next.

WTH??? Why is it still hard to get epipens and why are the dates so short and since when did insurance companies stop covering name brand of this?

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: MaryM on August 10, 2017, 12:55:32 PM
I have Cigna & it's no name brand anymore.  We asked for the Mylan generic.  Originally the pharmacy gave us the Adrenaclick (?) but it was too different.  The Mylan generic Is exactly the same but it does not say Epi-Pen.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: my3guys on August 10, 2017, 01:39:11 PM
Thanks MaryM. I'm so glad you told me you got the Adrenaclick! You made me open the boxes and it looks like I did too. The pharmacist was so nice and offered to take them back. He put in an order for the generic Mylan, like you suggested.

I also called Cigna, and they said we can get brand name, it requires prior authorization from a doctor, but they can get it. I'm told the difference is $80 give or take. Assuming I can get the generic Mylan, that's what I will do.

This is so frustrating!
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: MaryM on August 10, 2017, 03:45:25 PM
Glad I could help & that the pharmacist was able to order the Mylan generic for you.  My DD was very upset to not have an Epi-Pen until I let her compare the Mylan generic to the name brand. It's ridiculous.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: SilverLining on August 11, 2017, 10:39:26 PM
What is the cost of the Mylan generic?
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: MaryM on August 12, 2017, 07:15:23 AM
I believe w/o insurance its $300  :misspeak: but with my insurance I think I pay $30 for a twin pack. 
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: SilverLining on August 12, 2017, 09:30:09 AM
That's for generic? :o
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: SilverLining on August 12, 2017, 09:31:53 AM
The reason I was asking, there is a post on Facebook that people are sharing regarding generic epipens. I did point out the info is American (being shared by Canadians). But I also thought the price was inaccurate. It says it costs under $10.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hedgehog on August 12, 2017, 09:58:57 AM
It costs under $10 to manufacture. Or it could, I guess, cost under $10 for a copay with really good insurance.
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: gvmom on August 12, 2017, 12:02:14 PM
$284.45 per twin pack for generic pi-pen.

Ask me how I know.  With 3 FA kids.

 :disappointed:

Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: hezzier on September 30, 2017, 07:53:00 PM
Well this is interesting...

http://www.kmov.com/story/36490815/missouri-to-get-3-million-in-epipen-settlement
Title: Re: Cash Price of Epipen ... INSANITY!!!!!
Post by: nyguy on October 01, 2017, 08:10:34 AM
The reason I was asking, there is a post on Facebook that people are sharing regarding generic epipens. I did point out the info is American (being shared by Canadians). But I also thought the price was inaccurate. It says it costs under $10.


Generic EpiPen made by Mylan (AB rated to the EpiPen brand) is $300 list. Copay assistance is here, currently only $25 and only valid for patients with commercial insurance.

At one point Impax Pharmaceuticals was discounting their generic epinephrine auto-injector during the whole EpiPen debacle being big in the news to $109.99 list - $100.00 coupon (max value) = $9.99 cash price for people without commercial insurance (TIME article), but now the coupon (here) is only $50, so that's $60 cash price. You also have to get the prescription written for Adrenaclick instead of the EpiPen in most states, as Adrenaclick and EpiPen brand are not AB rated and pharmacists in most states cannot substitute one for the other.

At this point it seems like generic Epi is probably the cheapest for Medicaid/Medicare/Tricare (although somebody on those programs would have to tell me if I'm wrong and the price is more than $60) and Auvi-Q is probably the cheapest if you either have commercial insurance (Kaleo gets it to zero out of pocket regardless of whether or not your insurer covers it) or if you don't have commercial insurance and make less than $100,000 a year (patient assistance program gets it to $0).