Monopolies Kill People

I get to write about this one because TMC doesn’t think the headline is strong enough. While we are not prudes here, her proposal would make a sailor blush and I’m not sure how to transcribe the scream of rage that punctuates the end.

Also I have EpiPens, at her suggestion. I have pretty serious allergy to Bell Peppers, Red, Yellow, Green, and otherwise. I happened to tell her the story of how I was DJing at one of my club’s social functions and they served Potatoes O’Brien. What makes them O’Brien and not just greasy chunks of crunchy fried potato is that they add some diced Red and Green Bell Peppers. The entree was 2 paper thin slices of Roast Beef smothered in gravy to disguise the fact that it was mostly gristle and fat and the sides were an over boiled Broccoli/Cauliflower medly and the aforementioned Potatoes O’Brien.

I worked through lunch (I had other duties you know) and I was starving. Even though I knew it was probably a bad idea I scraped off the Peppers and ate the potatoes.

Soon enough I had a raging headache and my partner said, “ek, you don’t look so good. Your face is as red as a radish. You’d better lie down for a while.” So I did. I passed out for about 3 hours and when I woke up I didn’t feel great but I could function. My poor friend had been single handing it the whole time which is not as easy as it sounds so I helped him finish up and break down the system.

Well, in retrospect, to me it seemed funny which is why I tell the story but TMC had an entirely different reaction. She asked, “Were you wheezing?” A little I guess. “Next time you see your Doctor get a prescription for an EpiPen. You were in anaphalactic shock and you’re lucky to be alive.”

So I did. Since then, though I am very careful, she’s had the opportunity to see me burst into hives just from getting near the stuff and never misses the chance to give me that, “I told you so” look though she’s far too polite to say it. Instead she says, “Do you have your Benadryl? Take two.”

I do worry that I’ll find myself in a situation where I forget my pen or medication and experience a severe allergic reaction. I should really invest in allergy bracelets to notify medical professionals if I ever find myself compromised in this position, and potentially save my life.

I’m happy that I’ve never had to use the Pens because they’re very, very expensive even though I got mine before the latest round of price increases (I think it was around $250 or so).

Well, just what makes them so expensive? The research was entirely subsidized by the National Institutes of Health which is a branch of the U.S. government. They own the Patents on the delivery system (the Pen part which is also used for other drugs like Insulin and was purchased by the DoD to administer an antidote for Nerve Gas) except for the safety cap on the needle. It costs (generously) $2 to produce. Epinephrine itself has been synthesized for over 100 years, has no remaining Patent protection and costs $1 a dose.

Monopoly power.

In 2012 Mylan was forced to accept a consent decree allowing for a generic alternative to be marketed because of their 98% market share. Pharmaceutical companies, when faced with the imminent arrival of generic competition, frequently raise prices to milk the last few bucks out of their monopoly.

So what happened to the generic alternative? Teva, from an Israeli company, was unexpectedly rejected by the Food and Drug Administration. Why? Probably because they couldn’t afford the independent (but entirely redundant) testing required for their product. Auvi-Q, a competitor from Sanofi, was pulled from the market last year because of dosing problems.

Now there are other sordid aspects to this story. The CEO of Mylan, Heather Bresch, is the daughter of Senator Joe Manchin, Democrat of West Virginia. She successfully lobbied for the 2003 Medicare prescription drug bill, which barred the federal government from bargaining with drug companies over prices. In 2012 she lobbied for the Generic Drug User Fee Act which made it more difficult for foreign drugmakers to sell their products in the United States. Then in 2013 she was able to prioritize grant money for schools to stock EpiPens under a restrictive contract that did not allow competing products to be used. In her home State of West Virginia EpiPens are mandated in every school, no doubt helped by the fact that her Mother, Gayle Manchin, was head of the State Board of Education.

Also among her proud accomplishments (besides raising the price of EpiPens 450%) is raising her own salary by $16 Million to $19 Million annually AND guiding Mylan through a corporate inversion to avoid paying its fair share of United States taxes.

What an amazingly accomplished businesswoman, except of course, she’s not.

She’s lowered shareholder value by $3 Billion (12.4%).

She freely admits she only got the the job because of her Father. She didn’t even know what the company did. She claims to have an MBA from West Virginia University but only finished 22 of 48 hours of required course work. In 1999 she was given a degree (later rescinded) after being given passing grades in two courses that were “incomplete” and having the University give her credit for 6 classes she never attended. This bit of academic legerdemain was signed off on by R. Stephen Sears, the Dean of West Virginia University’s Milan Puskar Business School, on October 22, 2007. Milan Puskar was Heather Bresch’s boss at Mylan and West Virginia University’s biggest donor including a $20 million endowment in 2003. As a result of the “situation” (as she calls it) the School President and 2 other officials were forced to resign.

In Ms. Bresch’s defense she herself says, “Everybody does it. It’s standard practice. At least we ‘increased anaphylaxis awareness’.”

And they’ve lowered prices- not. Co-pay discount cards are a well known ‘Pharma Bro’ scam. They only cover co-pays, not the overall price of the drug. Insurance Companies, Institutions (Schools for instance) and the Government (if you happen to be on Medicare or Medicaid) get gouged the full price. Likewise those with high deductibles if they haven’t already reached their threshold.

At least 3 Senators are calling for Bresch to face a Congressional Hearing and frankly I think Joe Manchin should face a full fledged corruption and bribery investigation because if this is not quid pro quo then such an animal is as imaginary as a Jackalope.