Socialize the EpiPen

The EpiPen mess shows that we need drugs that function as real social goods, not rent-producing commodities

By Adam Gaffney, M.D.
Jacobin, Sept. 2, 2016

The ongoing EpiPen debacle has served one useful purpose: it has plainly revealed the uninhibited avarice — and general dysfunction — at the core of the American pharmaceutical system.

The saga of the EpiPen — and the chicanery of Mylan Pharmaceuticals, its merchant but not its maker — exemplifies a slew of troubling developments that have been unfolding throughout the pharmaceutical universe in recent years. Most prominently, of course, there is the appalling price-gouging: Mylan bought the EpiPen in 2007, at which point a pair of them went for about $100; then, as the New York Times reported, it proceeded to jack the price up, at an accelerating pace, to over $600 currently.

This massive and entirely arbitrary sixfold price increase produced a windfall for the company, and made its CEO Heather Bresch colossally rich in the process. Her annual salary skyrocketed from around $2.5 million in 2007, as NBC News reported, to an absurd $18.9 million by 2015.

What did Mylan do to rake in such kingly sums? It’s not quite clear. Mylan didn’t invent the drug or the autoinjector technology that is the EpiPen’s raison d’etre (this device essentially allows individuals to rapidly and easily inject a precise, preloaded dose of epinephrine into the muscle of themselves, or others, when in the throes of a suspected anaphylactic reaction).

Epinephrine, as many have noted, is today cheap as dirt and has been around for more than a century, while the essentials of the autoinjector date back to the 1970s. Indeed, as an article at Timeline describes, the EpiPen actually “owes its existence to public initiative.”

The Pentagon sponsored the development of an autoinjector that could rapidly deliver a nerve gas antidote in case of a chemical weapons attack. This is no aberration: the EpiPen is one of many medical advances whose early development was publicly funded, only to later serve as a source of enormous private profit.

But furthermore, Mylan doesn’t even make the EpiPen: it outsources that to Pfizer’s Meridian Medical Technologies, which manufactures a whole lineup of autoinjector products (including, incidentally, injectors for antidotes for nerve gas among other nasty poisons).

In short: Mylan and its CEO have gotten filthy rich off of a drug that they not only didn’t invent, but don’t so much as glue together.