CVS Announces Super Cheap Generic Alternative To EpiPen (arstechnica.com)

An anonymous reader quotes a report from Ars Technica: Pharmaceutical giant CVS announced Thursday that it has partnered with Impax Laboratories to sell a generic epinephrine auto-injector for $109.99 for a two-pack -- a dramatic cut from Mylan's Epipen two-pack prices, which list for more than $600 as a brand name and $300 as a generic. The lower-cost auto-injector, a generic form of Adrenaclick, is available starting today nationwide in the company's more than 9,600 pharmacies. Its price resembles that of EpiPen's before Mylan bought the rights to the life-saving devices back in 2007 and raised the price repeatedly, sparking outcry. Helena Foulkes, president of CVS Pharmacy, said the company felt compelled to respond to the urgent need for a more affordable alternative. "Over the past year, nearly 150,000 people signed on to a petition asking for a lower-cost epinephrine auto-injector option and millions more were active in social media searching for a solution," she said in a statement. The price of $109.99 for the alternative applies to those with and without insurance, CVS noted. And Impax is also offering a coupon to reduce the cost to just $9.99 for qualifying patients. Also in the press statement, Dr. Todd Listwa of Novant Health, a network of healthcare providers, noted the importance of access to epinephrine auto-injectors, which swiftly reverse rapid-onset, deadly allergic reactions in some. "For these patients, having access to emergency epinephrine is a necessity. Making an affordable epinephrine auto-injector device accessible to patients will ensure patients have the medicine they need, when they need it."

Comments

you mean capitalism works?

[wolfgang_spangler]

That whole supply/demand thing isn't a myth?

Unpossible.

Re:you mean capitalism works?

[Anonymous Coward]

Meanwhile, congressmen, SJWs, and the perpetually aggrieved wring their hands while the free market gets it done.

Next time, do something to make it easier for the CVSs of this world.

Re:you mean capitalism works?

[Anonymous Coward]

The issue there is that capitalism wasn't in play.

Due to the barrier to entry posed by drug regulation it cost too much for competitors to enter the same market, and would have remained that way if those assholes had not gone full retard.

Re: you mean capitalism works?

[Anonymous Coward]

Iff the practical economic ability to compete exists, safety regulations are enforced, collusion is prevented, consumers are educated well about their purchase decisions, etc.-- then capitalism works pretty darn great.

Re:you mean capitalism works?

[Daemonik]

The same free market is why Mylan could raise their prices to $600 or more. Pharmaceutical companies can set whatever price they want, there's no regulations against it, especially during their 5 year patent period.

Re:you mean capitalism works?

[Anonymous Coward]

For non patent drugs with a sizable market it is not a myth.
For Patented drugs and niche drugs it is.

Re:you mean capitalism works?

[Anonymous Coward]

Check your sources comrade. This drug has not been under patent for a very, very long time.

Re: you mean capitalism works?

[Anonymous Coward]

You mean I can't open a drug company to create an essential life saving drug for hundreds of thousands of people by tomorrow? :( *closes Wikipedia page on "Pharmaceutical manufacturing"*

Re:you mean capitalism works?

[scamper_22]

I completely understand the struggles people who are impacted by a disease and there's a cure out of there, but just costs so much.

At the same time, for all it's flaws in the patent system, in the grand scheme of things... the patent lasts like 5 or 10 or 20 years (I don't know). My point is it's not that long.

Let's remember that the drug wasn't there before. That's the price the society pays for a dynamic drug market.

You invent something; it's prohibitively expensive for a bit, then the price drops.

The alternative is... maybe it's not invented.

The former sadly is easy to rail against. The later is a bit more complex.

Re:you mean capitalism works?

[Anonymous Coward]

I am sure the people that couldn't afford epipens between when the price was raised and now are relieved that the market got there eventually.

Re:you mean capitalism works?

[Anonymous Coward]

The free market enabled it, and broken government regulations allowed it to last so long while CVS made it to market.

Things like the ACA have added miles of red tape into the mix, which is also enabling insurance companies to do exactly what Mylan has done.

Pharmaceutical companies can set whatever price they want, there's no regulations against it, especially during their 5 year patent period.

Quite obviously they can set whatever price they want, period. Mylan has owned the rights to EpiPen since 2007, which was now 10 years ago. EpiPen existed before then, so until someone was able to make it through the red tape with an alternative, they have raked in billions.

What's most amazing is that law makers, on both sides of the aisle, have postured and pretended to care. Yet nothing has been done.

I desperately hope that the Congressional term limit amendment passes. These human piles of garbage need to be sent packing before they get tied up in the powermill.

Re:you mean capitalism works?

[Anonymous Coward]

I honestly don't understand this problem.

An Epipen can deliver epinephrine in a couple of seconds for nearly a thousand dollars.

A readied syringe of epinephrine can deliver epinephrine in a *few* seconds for like three dollars.

Someone is being *incredibly* lazy (hint: everyone who has an allergy issue or who has a loved one who has an allergy issue).

The Epipen can't cost more that five bucks to produce. This is pure evil. But the fact that there is no alternative is pure lazy.

Re:you mean capitalism works?

[sjames]

And all it took was massive public outrage, several years and a Congressional hearing to get one drug long out of patent from outrageous to merely high priced.

Re:you mean capitalism works?

[thesupraman]

No, Regulatory Capture is however a thing.

And its the new 'capitalism' in the US, in case you wondered why costs of things a spiraling up, while the cost of such things in China have crashed.
They will happily tell you its for your own good. You NEED to be protected from paying value based prices for things, and instead gouged to support
'American Jobs' which are really just a few people getting VERY rich from the difference (because, American base manufacturing? dream on....).

Of course the Chinese dont generally pay a huge office building full of management, marketing, HR, etc - they just have a few people doing actual work.
They dont employ a bunch of very expensive people on capitol hill to stuff money into the right critters pockets to protect their positions, either.
But no, we still believe its slave labour, and the REAL cost of things is actually this high..

Get with it people, consumerism was used as a weapon again the middle classes. Much the same as low interest rates combined with hidden inflation
is being used as a weapon again the middle classes.
Your job is to work hard, spend everything, and keep your heads down.
Otherwise, you could actually start thinking, and realise that the morons in control are morons, who are only in control because you are playing their game.
Stop borrowing.
Stop spending on the latest slick marketing compaign that will 'make you a complete person'.
Start enjoying the nice things in life that are actually mostly FREE.
Turn off the television, stay out of the malls, stop worrying if the neighbor has a newer car or nicer sofa, or newer iphone.

But no, apparently that would 'destroy the economy'. You know why? because the rape of the middle class is whats keeping everyone else going.
Sheep to the slaughter.

Re:you mean capitalism works?

[HornWumpus]

None of those things did anything.

CVS is doing it for the money.

Re:you mean capitalism works?

[HornWumpus]

Like I suggested downthread, roll your own and post the design on 'hackaday'. Talk is cheap.

Re:you mean capitalism works?

[Daemonik]

Just because this is the only system you know, don't assume it's the only system that works. Before the 80's when boomers became determined to bleed every possible drop of profit out of the economy, hospitals were run by charities and the worlds most famous doctors worked at university teaching hospitals. Even today the majority of medical breakthroughs happen in universities with government grant money, not pharmaceutical giants.

There is credible evidence that in the unregulated free market once a company achieves market dominance all innovation becomes simple incremental upgrades as research money is transferred to investors. Just look at Apple for a perfect example.

For the people who keep saying regulations keep competition low... yeah, most people are perfectly happy with regulations that require companies to actually prove their devices work, they're well funded and their investors aren't gangsters.. so horrible that the people who invented Shake Weights might not be able to bring us their amazing magnet powered pacemakers I'm sure they were working on.

Re:you mean capitalism works?

[Ol Olsoc]

You know why? because the rape of the middle class is whats keeping everyone else going.

For a while it will work, and not much longer. Its genius really, that we have managed to get a lot of people to vote completely against their self interests.

Re:you mean capitalism works?

[Anonymous Coward]

The easy solution (same AC here), is for the government to simply rescind the patent and produce the device and distribute it at cost. Eminent domain. It's used for bullshit reasons like building a shopping center; this is the kind of thing it was intended for. These cutpurse companies have already made their millions (billions?), so let them bitch about it.

Maybe we could start funding science again and this type of thing would be public domain to begin with.

Re:you mean capitalism works?

[OhPlz]

Fuck you, seriously.

Doctors will not prescribe a syringe and epinephrine in a vial. Laziness has nothing to do with it.

Re:you mean capitalism works?

[Imrik]

The problem is that in this case the product was reasonably priced, then went up instead of down.

Re:you mean capitalism works?

[GerryGilmore]

Well, not counting the people who died while "capitalism" reconciled itself with basic human morality...I guess?

Re:you mean capitalism works?

[I75BJC]

Actually, it was differing Government regulations that permitted the travesty of Mylan's high price. The free market had nothing to do with it. This was in the Main Stream Media or "The News". The free market would have solved the problem much earlier but the Federal Government wouldn't let the free market work. (per Standard Operating Procedures of our Governments)

Re:you mean capitalism works?

[Anonymous Coward]

I said epinephrine in a syringe, not a vial. The dose is already there. You just have to take the cap off and push it in.

This is a legislative issue why doctors won't provide that. It should be protected under "Good Samaritan laws"

Just like it's a legislative issue why epipens weren't nationalized. (yeah communism).

So fuck *you* seriously, for failing to think about this. I don't have this problem, and I don't have a loved one who does, but I'm trying to solve it, and you're just being an asshole instead of working with me.

I hope a bee stings you and you die. That would be hilarious. And I would still be trying to solve this problem you dickhead.

Re:you mean capitalism works?

[Anonymous Coward]

Good luck trying to properly give yourself that injection while suffering from anaphylactic shock, can't breathe, and are about to pass out. If you think it is so easy then would you care to prove it by giving yourself a proper IM injection of saline while being waterboarded?

Re:you mean capitalism works?

[OhPlz]

You're blaming the people that need it for what you now call a legislative issue. You're a jackass. What, people should spend a few hours to become a legislator so they can push a bill to make this possible? In what version of reality is it the patient's fault that your magic low cost alternative isn't available?

I'm an asshole for not working with you? Try posting as something other than AC then. Or do people down-mod you all the time because they too see that you're a jackass?

You're not trying to solve anything. You're being a dick.

Besides which, your preloaded syringe probably wouldn't work. I don't think syringes are designed to hold their contents over a long period of time. Not normal ones anyway. That's why I mentioned a vial. Plus if it's not sealed somehow there's danger of contamination or spoilage. Even the Epipens can go bad, that's why the have the window on the side to let you see the contents.

Even this new thing that CVS is selling is way overpriced for what it is, but it's still a better option than the other stuff that's actually on the market.

Re:you mean capitalism works?

[Anonymous Coward]

"Good luck trying to properly give yourself that injection while suffering from anaphylactic shock, can't breathe, and are about to pass out. If you think it is so easy then would you care to prove it by giving yourself a proper IM injection of saline while being waterboarded?
"

No, that would be stupid. Maybe you could better educate people why epipens are so necessary instead of being a cunt.

If no one makes a better and affordable solution, make it eminent domain, just stop this stupid discussion. This is a product that costs *dollars* to produce and is being charged *hundreds* of dollars.

And... I may be ignorant, but I've seen anaphylaxis... I've experienced anaphalaxis (though due to hospital administered, and only hospital available drugs, so as soon as I started exhibiting symptoms I was surrounded by four ER people who were looking at me hard and asking me questions for quite a while until I convinced them I was fine). It has seemed to me that it was obvious to the participant that it was happening. As far as I know, and please prove me wrong if I am, it's not a matter of, "I'm fine", then three heart-beats later I'm dead. It's more a matter of, "I think I'm having a reaction, couple of minutes pass, no, I'm fine, couple of minutes pass, no, I'm an idiot in denial, now I'm dead".

And "properly give yourself that injection"? Epipens are injected through clothing-- you have a significant risk of infection from it. There is nothing "proper" about it at all. It is a high risk emergency procedure.

I completely recognize that I am probably ignorant. Point me to education. In the mean time, if heroin addicts can get their hands on drugs that will kill them (I have seen that happen, and then got the EMS there to reverse the process) and that are highly illegal, I find it absurd that allergics don't have stashes of drugs that can save and will only get the reaction of "Wha..?" from the police.

Officially-- I think this technology should be nationalized and freely available (like emergency medicine in general). I think anyone arguing against that is an inhuman monster, but if that can't be the case, that, for real, solve your own problem. Epinephrine is cheap. Needles are cheap. Figure it out.

Re:you mean capitalism works?

[Anonymous Coward]

Check your sources comrade. This drug has not been under patent for a very, very long time.

I assumed the story here is about the delivery mechanism, not the drug.

Re:you mean capitalism works?

[Anonymous Coward]

Wow-- representative democracy.

Legislators do the voting; tell them how to vote.

So, no, I am not telling everyone with an allergy to become a legislator. I'm telling them to be an active participant in a democracy-- sort of how we are having this discussion (anonymously, just like in most modern democracies-- why should I have to join some comany's agenda to speak my mind in public? You fascist schill).

Are drugs magically damaged when they are in a vial in a syringe as opposed to in a vial outside of a syringe?

And yes, I know that Epipens have a shelf life-- that's why their price is such an egregious affront to humaity-- BECAUSE YOU WILL PROBABLY NEVER NEED ONE, but you'll have to keep buying them if you want to survive.

(you stupid cunt).

Re:you mean capitalism works?

[dmr001]

I prescribed a vial and syringes a few hours ago. Not an EpiPen; in my case it was for a similar (but less sexy) scenario, naloxone, to use for opioid toxicity, a popular cause of death among opioid addicts and even those prescribed opiates for legitimate use. (The current recommendation is to prescribe an opiate-antagonist for those using over 50 morphine equivalents a day.) I just hope to heck if my patient ends up over-gorked on their meds they can find the syringe and draw up the medicine. (Injecting it is the easy part; you could do it through your pants blam! into the leg.) You can't keep a regular syringe pre-filled safely - the medicine doesn't stay safe. Luckily, naloxone doesn't need to be dosed carefully. Epinephrine does (too much could fry your heart). I suppose it's not so importnat to be precise as it is for insulin, but most people don't need to draw that up in a hurry.

Re:you mean capitalism works?

[Anonymous Coward]

That would be the case if this were "super cheap" but it's not. This is the equivalent of raising prices, and then putting the item "on sale" for the original price. If markets worked then it would be cheaper than the original price. Title should say the product is offered for the original price, not "super cheap"

Re:you mean capitalism works?

[Impy the Impiuos Imp]

If CVS did their usual trick of their own generic brand vs. named brands, this pen would cost maybe $500. They slightly undercut Tylenol, cough medicine, etc.

Good for them for this, but you have to go to the supermarket or a large retailer (you know who) to get significantly cheaper generic brands.

Re: you mean capitalism works?

[greenfruitsalad]

You guys would be surprised if you knew how much this epipen costs in most European countries. In mine, it's about 35 euro (for a single pen) if you're a tourist from outside EU. 4.40, if you have (compulsory) insurance (60/month). I regularly see American tourists attempting to buy these, but they're tied to a prescription.

Re:you mean capitalism works?

[DogDude]

Oh, kid, you're so naive and so uneducated. You should read a basic book about economics, and along with "supply and demand", you can also learn about "elastic vs inelastic demand" After you do that, then come back here, and make the same post, you uneducated twit.

Re:you mean capitalism works?

[dbIII]

At the same time, for all it's flaws in the patent system, in the grand scheme of things... the patent lasts like 5 or 10 or 20 years (I don't know). My point is it's not that long.

Not that long? Apparently the epipen was invented in the mid 1970s. Most of you here were not even born at that time.

Re:you mean capitalism works?

[Anonymous Coward]

If capitalism worked, two injectors for $110 wouldn't be our best option. Yeah, it's well below what Mylan charges; it's also still too expensive by at least a factor of four or five, and it's a back-breaking cost for the poor.

(Yes yes, I know, if they want to be alive they shouldn't be poor. How dare they.)

Re:you mean capitalism works?

[Anonymous Coward]

You must be young. My dad is allergic to bees. His doctor prescribed him a preloaded syringe in the 80s. This is how it used to be done.

Image of an old "bee sting kit":
http://wp.production.patheos.com/blogs/dirtheartwitch/files/2015/07/old-style-sting-kit.jpg

Re:you mean capitalism works?

[OhPlz]

So you've missed the countless news stories about consumers complaining about Mylan not to mention the government hearings and investigations. Sure looks to me that people are pushing it and yet you're still calling them "incredibly lazy". The only thing more they could do is get elected to the legislature to pass a bill themselves. Asswipe. I bet you're the anonymous twat that pisses on the toilet seat and leaves it for the next guy.

Re:you mean capitalism works?

[OhPlz]

They did a lot of things with needles in the 80s.

I haven't seen one of those before. That doesn't look like a typical syringe, so even if someone could get a script for one, I don't know if they could actually find a pharmacy to fulfill the order. If you guys think auto-injectors are over-kill, you'd love the Auvi-q that actually plays prerecorded audio instructing you on how to use it. My allergist wasn't impressed when I said that it was a pointless feature that I didn't want that probably only existed to drive up the cost of the gadget.

Re:you mean capitalism works?

[Anonymous Coward]

Medical equipment has artificial scarcity (in the form lf FDA approval), I suspect CVS did this for the PR and not typical supply and demand economic reasons.

Re:you mean capitalism works?

[Anonymous Coward]

If I'm not mistaken the government designed the epipen in the 70s.

The issue here is approved manufacturers, not patents.

Re:you mean capitalism works?

[Orgasmatron]

Here's the thing though... the poor don't pay $55 for these things. They also didn't pay $1000, or whatever.

The only people who ever paid $1000 or even $55 were middle class guys with Health Savings Accounts that hadn't yet reached their deductible for the year and rich guys stocking the first aid kits on their yachts.

Everyone else either has some sort of medical coverage (what we laughably call "insurance"), or if they are poor and somehow without a medical plan (medicaid is happy to pay for epi pens) the manufacturer would provide a coupon to get it for free or at some nominal cost.

Also, the people making their own are usually spending less than $20 each, which sets the rough ceiling for the free market cost. Mass production can probably bring that cost down to $5 or $10 each. But the free market isn't in charge here. You can't just design, build and sell these things. You need to beg for government approval.

Re:you mean capitalism works?

[Orgasmatron]

What does a basic book about economics have to say about the government suppressing supply? And does it say where in the retail price the other regulatory costs get hidden?

Re:you mean capitalism works?

[Actually, I do RTFA]

Yes, capitalism slowly works, to some degree. On the other hand, in Canada which uses socialism to control prices for medicine, an epipen two pack is still under $100, and thus cheaper than this "super-cheap" option from CVS

(BTW, this option still isn't considered a generic variant of the epipen; it requires a different prescription. That said, this drug fills the same niche.)

Re:you mean capitalism works?

[thegarbz]

You are of course right. In most of the sane world doctors would just prescribe epinephrine and leave the content and delivery method entirely up to the patient who can discuss the best brand / method of taking a drug with their local pharmacist.

The exception is very targeted drugs or drugs where the doctor is aware of a problem. e.g. when I get penicillin the doctor writes on the prescription form "Penicillin with a note that Patient cannot tolerate oral ingestion of the drug." The pharmacist then gives me a small bottle, points me to the needles, and then asks if I'm okay to do it myself or if I want to use the free nursing service to have the drug administered.

Re:you mean capitalism works?

[sjames]

Of course they're doing it for the money. The outrage over the EpiPen price means they get good publicity ( = money) for entering the market. Probably millions worth of free advertising.

Re:you mean capitalism works?

[SuricouRaven]

The drug in this case is not new at all, and certainly not patented. The patent is on the delivery mechanism: The injector that makes it practical and safe for a bystander with no training at all to administer it, or for the patient themselves to do so even if they are currently struggling to breathe and shaking in pain.

Re:you mean capitalism works?

[SuricouRaven]

An epipen was. But not this epipen. The original 1970s design is no longer approved by the FDA. The patent that caused this whole mess is on a refinement to the design that makes it safer to use.

Re:you mean capitalism works?

[silentcoder]

It's worth noting that, prior to the FDA's establishment, more than 80% of all "medicine" sold in the US were so-called "patent medicine". These drugs, contrary to popular myth, didn't all do nothing - most of them were filled with deadly and addictive substances (usually opium) which the buyers had no idea they were buying. They were marketed for things so completely unrelated that it's physically impossible one drug could treat them all - but they sure made you high.

In short - it was a disaster that killed far more people than it ever cured. In the post-FDA world, this problem has shifted exclusively to those things which the FDA cannot regulate due to congressionmen selling out suplements and homeopathy. A recent study found that 1 in 3 supplements contained no shred whatsoever of the plant they are supposed to have been derived from. Suplements kill people on a daily basis due to dangerous ingredients and a lack of proper warnings about correct usage - seeing as they aren't regulated and nobody is making sure they know what correct usage actually means.

Where regulation does not exist, neither does medicine.

Re:you mean capitalism works?

[angel'o'sphere]

The "drug" is only a phancy name for Adrenalin.

Well known and isolated first time 1901 ... there is no "drug entrance barrier" for a 120 year old "medical".

Furthermore, the "pen" costs perhaps $1 to manufacture and the drug itself costs so close to nothing it is hard to say.

Re:you mean capitalism works?

[Anonymous Coward]

Like saying the steering in your car works, when you are heading to a collition with a train and it takes an hour for you to turn the wheel. But hey, it turns, so it works! Too bad you only had 3 seconds to get out of the way.

Re:you mean capitalism works?

[meerling]

What free market? You sure aren't talking about ours, or else you don't know what a free market actually is. That's ok, the reporters and politicians are pretty ignorant about that, so nobody else can be yelled at too much for not knowing.

By the way, there was a great market for the stuff at it's old price pre 2007. These guys have found a way around the patents Mylan now holds, and so they are going for the gold by massively undercutting them using a fair market price, and at the same time score mega bonus points of public good will.

If it were truly a free market, Mylan wouldn't have been able to have prevente people from doing this years ago.

Re:you mean capitalism works?

[meerling]

It's not the epinephrine, it's the epipen that's got the protection.

Re:you mean capitalism works?

[Sique]

Applying a syringe is not something everyone is able to do. Applying an EpiPen (or similar device) is. Laziness has nothing to do with it.

Re:you mean capitalism works?

[peragrin]

Then why bother setting the list price at $600 if 99% of the people get it for 99% off?

You aren't making that much extra profit, and you increase your costs by a significant factor (distributing the coupons is a lot more expensive than people realize.)

So you spend 50-100% in administrative work to sell something and call it good? Why not save yourself your company, and the end users a ton of hassle and money and just keep the price reasonable for everyone to begin with?

I deal with manufacturers who do this all the time. it is laughable. The list price of a 100 amp electrical panel is something like $800 but no one actually pays more than $60-80 for one. Why bother with such a complicated scheme when you can simplify it for everyone?

Re:you mean capitalism works?

[Anonymous Coward]

The audio instructions are NOT for you you dumb fuck, they are for the person in the cubicle next to you who finds your swollen unconscious ass on the floor with a half eaten shrimp hanging from your puffy lips, and has no idea how that funny square thing works, or how to use it. You really thought that recording was for you? Seriously, the reason your allergist wasn't impressed is because he/she just knows that your gonna be a dead man due to your own ignorance.

Side note, my kid has one because he might have to rely on another 8 year old to save his life. HE understands what that recording is for, but it has escaped you.

Re:you mean capitalism works?

[Anonymous Coward]

I don't know the details here but it's possible that the epipen as was in the 1970s is considerably different to what is offered today and not considered safe/effective enough to be sold any more, and that those improvements are patented and still valid. It's a bit like saying automotive patents last too long because the first automobile was invented over a hundred years ago and yet there are probably still some current patents that are important to providing a legally acceptable vehicle today.

That's not to say that patents are issued correctly or for the correct time period, just that the patent stopping epipens being copied may not be related to the original 1970s product.

Re:you mean capitalism works?

[Solandri]

No, they're able to do it for money because Mylan stupidly raised the price. If Mylan had kept the price at what it was before they acquired rights to the EpiPen, it would not have been worth it for a competitor to pay to develop their own pen, put it through the arduous FDA approval process, and put aside money to settle liability lawsuits in case something went wrong. When Mylan raised the price, it suddenly became cost-effective for someone to do all that, so CVS did. They still would've done it even if there had been no outrage, because overpricing something just creates an opportunity for someone else to swoop in and underbid you.

Re:you mean capitalism works?

[Jon Peterson]

Route (how a drug enters your body) make a difference. You can't prescribe some mass of some chemical and then leave it up to the patient or even pharmacist to figure the rest out.

The exception is drugs that *are* route independent, not the ones that aren't.

Re:you mean capitalism works?

[Anonymous Coward]

User interface is essential is this case, since the epinephrine is often administered by others while the patient is passed out or choking. Which means the patient regularly needs to instruct people around on its use, and those people need to be able to find it in the patient's bag or coat quickly. It helps a lot if the way it works (same arming mechanism, same feedback click if you succesfully administered it) and looks (same size, which side is the needle and which side do I put my thumb) is standard. Often "have you ever been instructed on the use of an epipen?" suffices with teachers and trainers. Having people with allergies carry around vials and syringes is going to get people killed.

Nobody would accept fire extinguishers all having different user interfaces because of patenting issues. All things you only use in a panic should be standardized.

Re: you mean capitalism works?

[Anonymous Coward]

The specific rule about EpiPens was the result of private sector lobbying of the government. Please, tell us more about how corporations aren't attempting to undermine public ownership of the state.

Re:you mean capitalism works?

[tomhath]

Before the 80's when boomers became determined to bleed every possible drop of profit out of the economy, hospitals were run by charities

Interesting little fantasy world you live in.

What really changed medical care in the US was the Democrats' attempt to socialize it back in the '60s. They were afraid to take it over completely, so they went halfway with Medicare. That program guaranteed hospitals would be paid to provide unlimited and expensive care to the largest segment of their market. Profits soared and any incentive to hold down costs went out the window.

Re: you mean capitalism works?

[Anonymous Coward]

The pharma comp lobbied in a rule that epipen scrips can ONLY get epipens and not the generics.

They basically cheated by corrupting the government. It's practically legalized bribery.

Re:you mean capitalism works?

[Atryn]

That whole supply/demand thing isn't a myth?

Unpossible.

I think there is more to consider about this. Supply/Demand is nothing NEW. What is interesting here is a key component of "efficient markets" - that of "perfect information". Companies spend a lot of money on market research - which is essentially an inefficient cost in the market that perfect information would eliminate the need for. Now, you can never truly have perfect information, but you can get efficiency gains.

In this example, the crowd used online petitions to communicate a problem seeking a better market solution. That's the reverse of market research. It isn't "crowd sourcing", which I would argue is still initiated by the company. This is more like "crowd based" or "crowd initiated" (someone will coin a better term I'm sure). So, what I would ask is, generally speaking, will the use of online petitions (directed at specific companies or the market in general) become a new trend that leads to faster development of products and services for which a true demand exists?

It is kinda like having a kickstarter without the fundraising or the idea, just getting people behind the "problem" and establishing a viable market for whatever solution emerges.

Re:you mean capitalism works?

[mjwx]

I completely understand the struggles people who are impacted by a disease and there's a cure out of there, but just costs so much.

At the same time, for all it's flaws in the patent system, in the grand scheme of things... the patent lasts like 5 or 10 or 20 years (I don't know). My point is it's not that long.

Let's remember that the drug wasn't there before. That's the price the society pays for a dynamic drug market.

You invent something; it's prohibitively expensive for a bit, then the price drops.

The alternative is... maybe it's not invented.

The former sadly is easy to rail against. The later is a bit more complex.

You do know that most drugs are actually developed with public money. Universities and government funded research labs. That means we already pay the cost of development, testing, so on and so forth. If it were left up to what was profitable, we'd have almost nothing cured at all.

Also cures and treatments aren't particularly profitable. Big Pharma spends a lot of its research and marketing budget on "lifestyle" drugs which are mostly two things,

1. Hardness pills. Because people with waning libido's will pay anything.
2. Vitamin supplements. Not that these are expensive, but they're so cheap to make because they don't have to pass FDA or equivalent testing. That means they don't have to work, in fact it's better if they dont work because then they cant be accidentally scheduled. They make placebo's a dozen for the penny and sell them a pound for 12 to hipsters and middle aged mothers who think multi-vitamins make them healthy. Their main cost here is advertising, convincing the middle aged mothers that popping a pill each morning compensates for their bad lifestyle choices.

When it comes for a cure for an illness, Big Pharma contributes very little in its development, they just buy up the rights for cheap, manufacture it cheaply and charge a fortune for it. This is why many governments forcibly license patents for local companies to make the drugs.

Re:you mean capitalism works?

[GuB-42]

In less "free" countries like the UK and France, the Epipen two-pack (the real one, not the generic) costs $70 and $100 respectively. And that's before healthcare.

Re:you mean capitalism works?

[Anonymous Coward]

My doctor prescribed a vial and syringe for me as well. Coupled to a cheap amazon IM auto injector, I have a re-usable epi pen replacement that is not only cheaper, but easier to use. The auto injector is so much better to train family and colleagues to use than the official epi pen because it works like a push button rather than a stab, and I can actually fill a real needle with water so the test is legit and not that fake all-plastic epi pen one that isn't anything like the real deal. Does anyone know if this CVS one is a pushbutton operation, or is it a copy of the mylan epi pen's stab-motion activation? stabbing is just not as easy to train people to use.

Re:you mean capitalism works?

[Anonymous Coward]

I honestly don't understand this problem.

An Epipen can deliver epinephrine in a couple of seconds for nearly a thousand dollars.

A readied syringe of epinephrine can deliver epinephrine in a *few* seconds for like three dollars.

Someone is being *incredibly* lazy (hint: everyone who has an allergy issue or who has a loved one who has an allergy issue).

The Epipen can't cost more that five bucks to produce. This is pure evil. But the fact that there is no alternative is pure lazy.

The benefit of the auto-injector is that it's simple and easy to use, even when the person is an idiot and is panicking. It's really hard to fuck it up.
The same is not at all true when talking about a syringe and vial.

And as for an alternative, you might want to read this: science.slashdot.org/story/17/01/12/2129255/cvs-announces-super-cheap-generic-alternative-to-epipen

Re:you mean capitalism works?

[budgenator]

That whole supply/demand thing isn't a myth?

Unpossible.

Heather Bresch, CEO of MylanCorp and daughter of Democratic U.S. Senator Joe Manchin, engaged in price gouging in an FDA regulated industry on a medical device whose purchase by all US schools is required by Federal Regulation is hardly an example of a free market, in fact it would be a better example of Governmental interference in one.

Re:you mean capitalism works?

[budgenator]

No they could raise their prices because Heather Bresch, CEO of Mylan Corp is the daughter of Democratic U.S. Senator Joe Manchin, allowing her company to engage in price gouging in a FDA regulated industry on a medical device whose purchase by all US schools is required by theUS Dept of Education regulations.

Re:you mean capitalism works?

[stdarg]

I've always assumed it's some kind of tax scam. To take another example like medical costs.. an ER might have a negotiated rate with an insurance company that is 75% lower than what they charge an uninsured individual. My question is, does that mean if the uninsured person doesn't pay, the ER gets to write off the inflated price as bad debt? So in that case, boosting the price by 4x actually results in the write-off being profitable, assuming say 35% tax. In other words, hey we get to deduct $1000 against the profits we made on patients who paid, that's worth $350 to us, rather than hey we get to deduct $250 against the profits we made, that's worth $87.50 to us. But I don't know.

Re: you mean capitalism works?

[Bartles]

The epinephrine auto injector has been out of patent for a long time.

Re:you mean capitalism works?

[budgenator]

It's not the epinephrine, it's the epipen that's got the protection.

Wrong answer, Autoinjectors have been around for a long time, we're talking 1980's. Now they are a medical device and fall under FDA501(k) regulations, but anyone that can meet those requirements can enter that market.

Re: you mean capitalism works?

[Bartles]

Which has also been out of patent for a long time.

Re:you mean capitalism works?

[Anonymous Coward]

Yes, of course, it's all those Democrats. Must be fun living in a world where you can just blame the other side for all the problems with systems.

The amount of paperwork required to get Medicare repayments is still absolutely ridiculous. Electronic forms help, but when the paper equivalent can be measured in "reams per patient", it's still an extraordinary amount of work just to get paid for sticking a needle in a patient.

The incentive to hold down costs went out the window? Really? Medicare sets reimbursement limits on everything. You don't hold down the costs at your hospital, you lose money to Medicare patients. There are still many small practice doctors who won't take Medicare patients because they're less profitable and require more paperwork.

Yes, good that you got the Republican talking points, but maybe there's more to the story after all.

Re:you mean capitalism works?

[Anonymous Coward]

Really? Get a new doctor. I've read of plenty of US people getting exactly such prescriptions shortly after the price increase, so "Doctors will not prescribe..." is hyperbole.

How to make your own Epipen equivalent

I won't say it's easy to get such a prescription, but it's nowhere near "Doctors will not prescribe..." levels of impossible.

Re:you mean capitalism works?

[budgenator]

There are no patents that I know of, Mylan might have a patent on their particular style of autoinjector, but autoinjectors are a technology developed for the military 40years ago, well outside of patent protection. There certainly many servicable designs that have fallen out of patent protection. The drug epinephrine is a natural hormone produced by the adrenal glands and has been used medically for decades and first isolated in 1901. While a particular method to manufacture it could be patented, it's an inexpensive generic drug.
There is no reason why anyone couldn't get FDA501(k) certified, buy some product liability insurance, a few thousand unfilled autoinjectors and some epinepherine and go to town; that's what CVS did.

Re:you mean capitalism works?

[budgenator]

Hitting a vein with epi can be exciting, but hey the Pt is likely to die without anyway. We had a guy shot 2mg of atropine into his thumb with an autoinjector, well not the whole 2mg as the needle buried itself into the bone.

Re:you mean capitalism works?

[Anonymous Coward]

That whole supply/demand thing isn't a myth?

Unpossible.

More importantly, government meddling in Capitalism is destructive. This whole EpiPen situation is caused by Medicare by creating an artificial monopoly. Mylan was pretty good when it came to marketing and raising awareness, so good in fact that the EpiPen brand became synonymous with adrenaline injectors. Many people believe that EpiPen is the only one available, but it's not and never has been. There's no patent protection because it's just an auto-injector, it just shoots adrenaline so there's no special chemical know-how; there's nothing stopping people from entering the market.

Except the fact that Medicare made a choice to cover only EpiPen and no other brands. Adrenaclick is a generic brand, but as it's not covered by insurance you have to pay $142 for it. As every other insurance company is required to cover what Medicare covers, then EpiPen is covered by all insurance but Adrenaclick is not. Because the consumer doesn't see the purchase price of EpiPen as insurance foots the bill, the consumer will always choose EpiPen because from their perspective EpiPen costs $0 (and insurance gets charged $600), whereas the generic costs $142.

This is a problem in any drug-cost covering insurance plan; the true price is hidden from the decision maker so the decision maker cannot make correct economic choices. If Medicare had set a base reimbursement price for any adrenaline pump, this wouldn't be an issue. If Medicare had set a base percent reimbursement price for any adrenaline pump, then patients would see the true price and supply and demand would prevail. Instead Medicare created an artificial monopoly and the public suffered as a result.

Re:you mean capitalism works?

[OhPlz]

That's not what it's for. If you ever take first aid training, they tell you explicitly that you're not supposed to do that. You can kill someone epinephrine. Besides which, unless you're wearing the thing around your neck, how would they know you have one? It's for use by the person with allergies to give them enough time to call 911 and wait for rescue. Kids absolutely shouldn't be messing with medication unless it's their own and they've been taught very well on when it's appropriate to use. Even then it doesn't sound like a good idea.

Re:you mean capitalism works?

[Anonymous Coward]

The issue in not Patents here.
The Drug is Off Patent and That is not the only design for an auto injector.
it is the N.R.E. to get it qualified and FDA approved.

Re:you mean capitalism works?

[Anonymous Cow Ward]

Regulations are why it's taken so long for a competitor to arise. The solution to bad regulation shouldn't be more regulation, it should be fixing the bad parts.

Re: you mean capitalism works?

[ZipK]

Which has also been out of patent for a long time.

Mylan's four patents related to the EpiPen do not expire until 2025.

Re:you mean capitalism works?

[ZipK]

Mylan has four patents on their particular instance of the autoinjector, that run into 2025. Anyone who can build an autoinjector that does not run afoul of Mylan's patents is welcome to enter the market.

Re:you mean capitalism works?

[thegarbz]

Thanks for stating the obvious. I mean you are just agreeing with me given the example I gave where when something is route dependent the doctor prescribes the route in question.

Or are you maybe suggesting that 1mg of epinephrine injected is different than 1mg of epinephrine injected? Because that's the topic being discussed.

Re:you mean capitalism works?

[Anonymous Coward]

At this point why would I believe anything a democrat says? "If you like your doctor, you'll keep your doctor" being the first of many healthcare related lies.

Re:you mean capitalism works?

[ilctoh]

Anaphylaxis is a acute state where a few Very Bad Things are happening all at once, and very very quickly (over the course of a few minutes.) The key ideas are:

• The air passages in your throat and lungs swell shut so severely that you cannot physically force air in and out. Within a matter of minutes, you will loose the ability to breathe. Period.
• At the same time, your blood vessels are rapidly dilating, causing a dangerous drop in blood pressure. This is why its commonly called anaphylactic shock, because your blood pressure has dropped to the point that the blood cannot adequately perfuse vital organs, namely your brain and your heart.

So between the fact that you can't get oxygen into your lungs, and the fact that your blood can't deliver oxygen to your brain, and the fact that you feel like shit, and know very well that you're in the middle of a life-threatening emergency... you don't really have the capability to perform tasks requiring concentration and fine motor skills, such as would be required to manually draw up a precise dose of medication into a syringe and inject it into yourself.

An EpiPen or similar device is "necessary" because it is an incredibly simple mechanical device that you can operate even while in extremis. You pop a cap off both ends, and push it against your butt check. Its something that anyone, even children, can be trained to do, and to practice (obviously with a dummy device with no needle or medication). And practice until using it practically becomes a reflex, and not something that requires concentration to perform. Its easy enough to do that, even when overcome with anxiety and decrease oxygenation, people can usually manage to work an EpiPen.

I suspect you probably haven't actually experienced anaphylaxis, if people had time to talk to you and for you to convince them that everything was fine. Anaphylaxis requires rapid administration of epinephrine. So you may have had an allergic reaction, maybe even a bad one, but unless you actually experienced the sensation of being unable to force air in and out of your lungs, even when trying with all your might, you haven't truly experienced anaphylaxis. I'd also take issue with your assumption that administering an EpiPen is a "high risk emergency procedure." I suppose there is some risk of local infection, but I'm not aware of any documented cases of infection, at least anything requiring treatment, as a result of an EpiPen. (There are other risks associated with Epi administration, but infection is effectively not one of them.)

So some sort of autoinjector device, be it an EpiPen or a similar competitor, is effectively required to be able to safely manage anaphylaxis.

Re:you mean capitalism works?

[waveclaw]

Let's remember that the drug wasn't there before. That's the price the society pays for a dynamic drug market.

No, the epipen was cheaper before Mylan CEO Heather Bresch decided to jack the price to +$600. Of which the company claims to only make $50, a really nice profit for something some people need. That is ignoring the insanity of that $550 overhead. An epipen is a single use stick needle. It delivers a $5 dose of a drug needed to stop anaphylactic shock. Outside the United States these pens are below $10.

You invent something; it's prohibitively expensive for a bit, then the price drops.

Nice theory but reality is different. The dark side to supply and demand is that if you need something, you don't have a choice to buy it. Whatever price I chose to sell it to you is what you have to pay. You want to stay healthy so you need Medicine. Since medicine is something you need, you'll pay whatever price or suffer. If I can make enough profit I can even afford to make sure nobody else competes with me. Either I can create a premium brand like the iPhone or just break the kneecaps of anybody who competes with me like solar roofs versus the local power monopoly.

The best business is to charge people for nothing, like sham medicine. The second best business is to take something that was cheap and already exists then resell it for really high profits.

And because of the first problem the FDA regulate markets like medical products very carefully. You may have to pay more since providing something real is more expensive than just cheating you out of your money. But you shouldn't be getting sham products.

The FDA doesn't regulate the cost to consumers, though. The would require a different, non-existent government organization in the USA. Something like a single payer medicine program.

Re:you mean capitalism works?

[liquid_schwartz]

Meanwhile, congressmen, SJWs, and the perpetually aggrieved wring their hands while the free market gets it done.

Next time, do something to make it easier for the CVSs of this world.

The notion of free market is an absolute joke when it comes to medical. If the free market were in place buying drugs from Canada would be possible. Instead the FDA, in conjunction with the Feds in general, show that their primary purpose is to protect big companies while screwing over the ever dwindling middle class. Note that this is not a partisan issue, both major parties play along.

Re:you mean capitalism works?

[HornWumpus]

You are halfway to wisdom.

Don't believe _anything_ a politician says.

Re:you mean capitalism works?

[Archangel Michael]

The problem isn't the drug, it is the delivery system is patented. Use a different delivery method (syringe) and you're fine. The problem is that Epipen has not competition. Price point where it is now, will create competition ... and you are seeing that right here.

Remember kids, this is an artificial monopoly with a couple different barriers (patent, FDA approval) that prevent competition.

Re: you mean capitalism works?

[See Attached]

Some should kickstart a company to build/sell Epi pens for $50. Then capitalism works. The cost of a product should drop to the cost of constituents, plus cost of labor and production, plus -some- R&D, and plus some profit. Then.. another kickstart can cut those costs... and drop prices further.. The "substantial equivalent" is a powerful alternative. Not an expensive drug, as I understand?

Re:you mean capitalism works?

[Anonymous Coward]

Except in this case there is no patent. The "drug" is epinephrine (adrenaline) something we've know about for a century. The original injector of this type dates back to the 80s. There is no reason that it should cost $400 or even $100. The manufacturer of the new generic is offering a coupon for low income folks that cut the price to 10%. Yes $9.99...

Re:you mean capitalism works?

[Anonymous Coward]

The injector is old news these type of injectors have existed since the early 80s. Sure there are newer patented designs, but they are minor enhancements.

Re:you mean capitalism works?

[Anonymous Coward]

Only it's not. The technology to safely inject medication by the average person is old news. The Epipen 1st came onto the market in 80s.

Re: you mean capitalism works?

[Anonymous Coward]

Facts? What do you think this is? A serious debate? This is Slashdot you assclown.

Re:you mean capitalism works?

[Anonymous Coward]

They still would've done it even if there had been no outrage, because overpricing something just creates an opportunity for someone else to swoop in and underbid you.

Makes me wonder why the world had to wait so long for Harry's Razors. The only reason Schick Razors don't cost as much as an epipen is because people don't need to shave to stay alive. As it is they are simply needlessly expensive, not obscenely expensive and have been for a long, long time. Then Harry's came along with a dirt cheap by comparison, and comparable product in the last couple of years. I hope al other razor makers are forced to take a long hard look at their business model now.

I'm a type 1 diabetic, and I need to inject insulin to live. Every day for the rest of my life. The cost of a vile of the stuff has risen 350 percent in the last 5 years.

Re:you mean capitalism works?

[dbIII]

There's a vast amount of that in the health industry where frequently the new patent is written in such a way as to also prevent competitors being able to use the old one.

Re:you mean capitalism works?

[dmr001]

Epinephrine and naloxone are both typically injected in muscles - no need to hit a vein. You can use epinephrine subcutaneously (just under the skin) but IM seems to work better.

Re: you mean capitalism works?

[Bartles]

That's great. But an you don't have to infringe on mylan's patent, to make a generic epenepherine auto-injector as other companies have done.

Re:you mean capitalism works?

[Chrontius]

The roll-your-own kit actually costs about $35 if you want to build an epi-pencil. $30 for the reloadable autoinjector, $5 for consumables.

Re:you mean capitalism works?

[Orgasmatron]

Only a few people get it discounted. Most people have insurance, either private or through government. They get a prescription, and they pay their $5 or $10 copay to fill it, the insurance company pays the difference between the copay and the negotiated price (typically 10-20% less than the list price). Note that I said "negotiated price" - they could get themselves a better deal if they wanted to.

The insurance company (including Medicare or Medicaid) isn't happy when the price goes up, but it is still vastly cheaper than the alternative, and for them, it is a tiny drop in a huge bucket, and apparently not even worth the effort of negotiation.

Meanwhile, the company that developed it got a huge cash infusion to finance future projects while everyone is putting on a show of indignant outrage directed towards the company that figured out a clever way to make a little profit by funding medical research.

Good for CVS

[stabiesoft]

I hope Mylan learns their lesson that gouging has consequences sometimes. Can you see ANYONE buying the Mylan epipen now even if they lower the price back to what it was?

Re:Good for CVS

[Motherfucking Shit]

Can you see ANYONE buying the Mylan epipen now even if they lower the price back to what it was?

They're out there; some woman interviewed on NBC Nightly News this evening said she won't trust anything other than the original EpiPen.

Re:Good for CVS

[Anonymous Coward]

yes. most definitely. Brand recognition is very powerful.

Re:Good for CVS

[Anonymous Coward]

Which I'm certain she said without any undisclosed sum of money being involved...

Re:Good for CVS

[CaptainDork]

This.

For many years, my wife insisted on brand-name aspirin, changing products in step with the most convincing advertisements.

Re:Good for CVS

[PRMan]

Yes. All the school districts that have 5-year exclusive contracts.

Re:Good for CVS

[Anonymous Coward]

You just publicly wrote that your wife is an idiot. That's a dorky thing to do.

Re:Good for CVS

[OhPlz]

She may have said that because of Auvi-q that was pulled from the market because it didn't inject the right dosage.

Re:Good for CVS

[Anonymous Coward]

Did they at least cut her off before she started screaming "INFOWARS" and ranting about gay tadpoles?

Re:Good for CVS

[OhPlz]

Huh? Why are school districts stocking medications?

Re:Good for CVS

[OrangeTide]

EpiPen has the best injection mechanism. Is your loved one worth $600 or $110 ?

Re:Good for CVS

[Anonymous Coward]

and there is an entire website dedicated to people saying stupid things...i think it is called youtube.

Re:Good for CVS

[h33t l4x0r]

Can you see ANYONE buying the Mylan epipen now even if they lower the price back to what it was?

How about anybody with health insurance that covers it?

Re:Good for CVS

[h33t l4x0r]

Ok but admit that, given a choice, when your kid goes into anaphylaxis, you're not going to reach for the generic.

Re:Good for CVS

[Anonymous Coward]

Laws in at least 11 states require at least public schools to have them on hand.

Re:Good for CVS

[Anonymous Coward]

brand-name stuff is more trustworthy as far as quality control goes. I trust Bayer to protect their brand with quality controls more than I would whatever chinese company du jour is putting pills into the bottle with the "equaline" label. don't ask me for sources, it's just one of those things that is logically true. if you travel outside the us, the generics are much worse quality than brand names. places like russia is absolute shit, but even places like france - big difference. in the us it's better. I don't trust contaminants in generics either, but the real problem is expiration. stuff like paracetamol or naproxen just gets weaker so it's fine. expired aspirin burns holes in flesh.

and as far as aspirin, look up the nasty flesh-eating form expired aspirin turns into and tell me if you really trust the date on that random equaline bottle with pills from who knows what company to go into your stomach.

yeah, I get it. stupid small chance of bad. but with bayer - a much stupider smaller chance of bad. you know what else is stupid small? two bucks.

given that, I always buy generic shit for things that lose potency. I never buy generic shit for things that turn dangerous. but for that you need to know shit about shit you take. can't be stupid and small. and lemme tellya - big ol dick right here.

Re: Good for CVS

[Anonymous Coward]

I convinced my wife to stop buying name brands after showing her they are mostly made in Bangladesh and other third world countries with poor product safety records, while most store brands are made right in our own city (Montreal, Canada)

Re:Good for CVS

[Anonymous Coward]

actually, you just publicly showed that you're an idiot by not knowing much about aspirin. you also showed yourself quite the dork and a loser by saying "you publicly wrote your wife is an idiot - that's a dorky thing to do"

I'm pretty sure you're a 16 year old pimple nerd though, so you have time to climb out of your social portapotty. start by looking up what aspirin is and what it degrades to. then learn to not talk like you do.

between the guy, his wife, and you - the only normal person seems to be the wife.

Re:Good for CVS

[Anonymous Coward]

No, epipen does not have the best injection mech, only the best known brand name. If you want to waste $500 on your loved one, how about a palm reading or witch doctor? I'm sure you love them and think they are worth the extra money.

Re:Good for CVS

[Anonymous Coward]

Im gonna reach for the closest item that I can AFFORD

Re:Good for CVS

[dbIII]

Not everyone thinks that way. The generic has to be good enough to qualify so is going to be equivalent in every way that matters even if the packaging isn't as pretty.
Maybe you've just overdosed on the "only the best" shit from having Trump in your face all year.

Re:Good for CVS

[h33t l4x0r]

So you are willing to risk the generic not being good enough when the difference is $300 vs the life of your child?
Just out of curiousity, what if I told you that 1 time in 10,000 the brand name will make the difference over the generic?
If you still say no we will have established a monetary value for the life of your child.

Re:Good for CVS

[David_Hart]

Ok but admit that, given a choice, when your kid goes into anaphylaxis, you're not going to reach for the generic.

Given time constraints, I somehow don't think that Dad or Mom are going to run to CVS and browse for an Epipen. "Which one should we get Dear?" The only useful one is the one you have with you or the one in the ambulance.

Since there is no difference in what is in the pen and they have the same effect, there is no reason to buy the more expensive one. Either way, it's a temporary measure until you can get the person to the hospital.

Re:Good for CVS

[jonwil]

And how long will health insurance keep covering the more expensive option instead of insisting people use the cheaper option?

Re:Good for CVS

[thegarbz]

Ok but admit that, given a choice, when your kid goes into anaphylaxis, you're not going to reach for the generic.

So when your kid goes into anaphylaxis and you're given the choice of injecting 1mg of epinephrine or 1mg of epinephrine, you'll go with what the TV advert tells you to do? No, I will definitely reach for the generic.

There is zero evidence that generic drugs lack quality. In fact the FDA's own website has a handy pictorial guide where the key picture is the one that says "Generic = Brand".

Actually there are plenty of studies which show all you're doing is giving money away so next time you're having an anephylactic shock just hand me your $600. I'll treat you with the same care a Mylan drug would and I get some spare spending money.

Re:Good for CVS

[SuricouRaven]

Insurance companies rarely pay the sticker price. What they pay and what you would pay can be very different figures.

Re:Good for CVS

[h33t l4x0r]

The hypothetical is, knowing the price difference, which do you choose in an emergency when your child's life is at stake.
If you truly believe there is no chance the brand name is more effective, you might as well take the generic.
But how will you feel, if your child dies, knowing that your cheapness may have cost his/her life?

Re:Good for CVS

[h33t l4x0r]

Ok but have fun showing your charts and FDA pictorial guides at your kid's funeral. There's an emotional component to decisions like this is what I'm saying.

Re:Good for CVS

[Anonymous Coward]

Gees, where did you get your chemistry degree? Aspirin can be made by reacting acetic acid with salicylic acid to produce acetylsalicylic acid, the same procedure used by Dr. Hoffman nearly a century ago. When acetylsalicylic acid ages, it may decompose and return to salicylic acid and acetic acid.

Is strong acetic acid dangerous? Sure, but unless the aspirin is really broken down, it's harmless. If it smells like vinegar, don't use it.

Re:Good for CVS

[silentcoder]

When people say something is "logically true" so they don't need evidence- they are almost always defending a position that, when you look at the evidence, turns out to be utterly false.

So for example it is "logically true" that gun control won't stop mass shootings because "anybody crazy enough to go on a shooting spree won't let gun control laws stop him getting an illegal gun" - it seems even more true if you consider that no gun-control country has managed to completely eradicate trafficking in illegal guns. There's just one problem - the logic doesn't match reality. The US has had more mass shootings in the past 20 years than the next 30 countries combined... BY MORE THAN TWO TIMES. The next thirty countries combined had 22 mass shootings alltogether, the US had 48 in the same time. Now why would this happen ? Why is the logic wrong ? Because it fails to consider the facts. Fact is, mass shooters are almost never career criminals. They have no contacts in the criminal underworld - and buying illegal guns is not easy. The guys selling them won't just sell them to anybody who shows up at the dockyard -the risk of it being an undercover cop is too high. You need people in the underworld who knows you and will vouch for you. You need to know where to go, who to talk to, what not to say... it's just not that simple.

It's "logical" that reducing government spending must also reduce government debt. Except that every time in history a government has reduced spending their debt went UP - there's literally no example of the "logical" prediction happening - not ever. When you consider ALL the facts - it starts to make sense. Every expense is somebody's income, this just just as true of government spending. Government cuts spending, that cuts income from citizens, and from the people they would have bought from. Most government revenue comes from taxes on income - so you cut a huge chain of income, that means cutting your own revenue by a massive amount. It's been mathematically proven that the revenue loss from austerity MUST always be greater than the savings, it's impossible for it it not to be. So in reality, austerity turns out to be about as effective a way of bringing down debt as burning your paycheck to save on your heating bill.

Lots of things are logical - but don't hold up to scrutiny because the evidence prove that the logic is, in fact, wrong because it didn't include all the relevant factors.

Your logic falls in the same category. The headlines are filled, daily, with massive scandals by big name brands- they happen constantly. So why is your logic wrong ? Because, it turns out, the risk of getting caught doing something horrible is relatively low, and usually you can get away with it for several years before you get caught. So why not do it? Any harm to the brand will be years away, after you made billions in profits, more than enough to cover whatever may be lost in future due to brand-harm, and anyway that will be some other CEO's problem to deal with, you'll have walked out with your golden parachute long before the crows come home to roost.
Where DOES It happen ? When the bad things are done by somebody else, and the knowledge of it happening is already leaked. The tylenol poisoning case was such an example. Tylenol didn't poison their own medicine, they had every incentive to do a massive recall to prevent harm to the brand - because they were not profiting from the bad thing that caused the harm and it was ALREADY DISCOVERED. But this rare - the vast majority of horrible things done in the world are done by corporations to their own customers and the second most common variety are done by corporations to their own workers. The only reason that's the order is because corporations usually have more customers than workers - it has nothing to do with the severity of the horrible things.

Re: Good for CVS

[Anonymous Coward]

That would be a sharp knife. Put the kid out of his misery, save the money on the drugs AND the defective kid. Win-win.

Re:Good for CVS

[Anonymous Coward]

Actually, yes. And so did my parents. Because they understand that :
1.) Generic drugs are the same thing except for the fancy packing.
2.) Generic drugs are also subject to the same regulatory compliance.

So, that 1 in 10,000 chance doesn't exist.

Re:Good for CVS

[oji-sama]

Just out of curiousity, what if I told you that 1 time in 10,000 the brand name will make the difference over the generic?

"Source please"

Re: Good for CVS

[Anonymous Coward]

TL;DR.

Re:Good for CVS

[Anonymous Coward]

There's also a 1 in 10,000 chance that it's the other way around, that the generic is better. You simply don't know and you cannot know. All you know is that both products passed.
The only thing I'm certain of getting for that $300 is prettier packaging, which doesn't seem so useful to me. That $300 is better spent improving my child's health in other ways; it's a matter of how many healthy years she's going to get for my dollars, and buying brand name doesn't optimise that.

Re:Good for CVS

[Anonymous Coward]

So you are willing to risk the generic not being good enough when the difference is $300 vs the life of your child?

Just out of curiousity, what if I told you that 1 time in 10,000 the brand name will make the difference over the generic?

If you still say no we will have established a monetary value for the life of your child.

So do you ever drive your child to school? Do you drive your child to the mall or anything else which is frivolous? What are the road fatality stats in your part of the world? Do you home school?

If you don't trust the regulatory bodies to evaluate the generic versions, how can you trust them to maintain product quality verification with the brand version?

Look it's an adrenaline injection. If it does not work, you may need to repeat it after 5 minutes if symptoms are worsening. If you can only afford one, you are in trouble, if the ambulance does not get to you before you need a second dose. I would personally prefer to have 2 approved generic ones located at different locations, maybe one at work and one at home then to only be able to afford one.

Re:Good for CVS

[Anonymous Coward]

He's saying he doesn't feel there's any reason to believe the generic has a higher risk of not being good enough than the branded product.

Just out of interest if the chance of something making a difference for your child was 1 in 100,000,000 and the cost was sufficient that it would mean you'd have to forgo any saving for them, your retirement, access to quality education or non-critical medical services etc would you pay anyway? Because if you would then you've got a serious issue with critical thinking and if you would then the only difference is the Cost Benefit analysis weighting between this example and your own example.

Re:Good for CVS

[Anonymous Coward]

What if I told you that 1 time in 10000 the generic will make a difference over the brand name? Guess you'd better rush out and buy the generic one quickly. We can all tell each other things, do you have evidence that shows the brand name performs any better...

Re:Good for CVS

[Anonymous Coward]

Because stocking medications sounds much better in the press than dead kids.

Re:Good for CVS

[Anonymous Coward]

Just out of curiosity, what if I told you that 1 time in 10,000 the generic will make the difference over the brand name?

There's as much evidence for my scenario as yours.

Re:Good for CVS

[Slashdot Junky]

I'd venture to say that most people with loved ones will say they are worth far more than $600. Think really big numbers and maybe even something like "there is no price". The problem with cost here is a practical one. There still isn't enough of it for so many even when compromises are made. Individuals and institutions aren't buying one unit. Individuals and families, in particular, apparently are buying multiple EpiPens so that they are always near. So, it becomes a much different total cost as one multiplies $600 versus a unit cost of $110.

Re:Good for CVS

[Anonymous Coward]

you also showed yourself quite the dork and a loser by saying "you publicly wrote your wife is an idiot - that's a dorky thing to do"

In his defense, he was responding to CaptainDork. Do you lose a lot of hats? I'm guessing there's a lot of 'whoosing' going on over your head.

Re:Good for CVS

[Anonymous Coward]

The generic has to be good enough to qualify so is going to be equivalent in every way that matters even if the packaging isn't as pretty.

Sometimes good enough isn't. My wife is completely lactose-intolerant. We used to buy generic lactase enzyme pills from CVS, but switched to a brand-name version (Lactaid) and found they were *much* more effective.

We subsequently discovered that CVS' quality control over their supply chain for generic over-the-counter meds was pretty terrible. This was from a trusted source so I cannot provide a citation.

Prescription meds are probably controlled differently than OTC meds in terms of quality, however (one would hope).

Re:Good for CVS

[rwise2112]

and there is an entire website dedicated to people saying stupid things...i think it is called youtube.

I think you misspelled Slashdot!

Re:Good for CVS

[Anonymous Coward]

If you still say no we will have established a monetary value for the life of your child.

Do you have the very latest model of the safest car on the road? Are there fire extinguishers in every room of your house? Have you hired private guards 24/7 for your children? Why not? Do you not value your children?

Re:Good for CVS

[stabiesoft]

Yes because it is not 300 bucks, it is 500. They come in 2 packs only. Further they expire after one year, so its 500/year. Further still many people buy more than just 2, since it is more about having one within easy reach. So often people buy 4 (2 pair) so now we are talking a grand a year difference. Some people just don't have a grand to spare so they were doing without. Lastly, if FDA said it was good enough, its as good as the name brand.

Re:Good for CVS

[Anonymous Coward]

It is literally the same thing.

Re:Good for CVS

[adolf]

Oh, the "you get what you pay for" logical fallacy, with a side of "I made this up."

What if I told you that 1 time in 10,000 the generic will perform in circumstances where the brand name won't?

(I can make shit up, too.)

Re:Good for CVS

[Anonymous Coward]

If you can't afford the extremely over-priced Epipen, and you need epinephrine to save your child, deciding not to get the much cheaper generic is not a logical decision unless you hate your kid.

As others have said... Epinephrine is epinephrine, and the best epinephrine to use in an emergency is what you have with you even if it's not the Epipen.

If the first aid person who comes upon your choking self has NO type of injector available because the Epipen was too expensive and you didn't "trust" the generic, you better hope they have some epi and a syringe in their kit, or your done. For severe reactions, the amount of time during which epinephrine will be able to save you is measured in minutes. And the amount of time you have to save yourself from a severe reaction before unconsciousness can be less than a minute.

Generic vs. Brand name only matters for a few prescription drugs, and epinephrine is not one of them.

Re:Good for CVS

[Anonymous Coward]

To prevent dead kids. Next question!

Re:Good for CVS

[budgenator]

Not infrequently the "Name Brand" and the Generic are manufactured on the same production line, sometimes the color of the coating is tweeked a bit.

Re:Good for CVS

[CaptainDork]

Not at first.

I'm going to reach for the mouse and Google, "anaphylaxis."

Re:Good for CVS

[Anonymous Coward]

not a lot of "whoosing" going on here. don't know what that means even - is that the dialect they use in Canadia? Learn some English dumbfuck.

yeah. his response to "CaptainDork" is what a nerdy dork would try to say to be funny. That's what I wrote. What are you not getting here sherlock? I'm going to guess you need an esl course. do the needful, learn the language.

Re:Good for CVS

[budgenator]

Since there is no difference in what is in the pen and they have the same effect, there is no reason to buy the more expensive one. Either way, it's a temporary measure until you can get the person to the hospital.

What is likely happen now is the Insurers will say an Epi autoinjector is a covered benefit, and it's covered at $109.99. Now if Mylan wants to sell Epi-pens and have it cover by insurance, it'll be at $109.99; if they don't play ball, the pharmacies wouldn't have enough volume to justify stocking. The Insurance have a contract with Providers and almost always it's a violation of the contract to sell to a patient for cash for more than the allowed amount for a covered benefit. Sometime a Patient will strike up a side-deal to get the "good stuff" for cash, but sooner or later somebody submits it to Insurance and the Provider gets busted, sued, all of the side deals come out in discovery, and all of those Patients get reimbursed.

Re:Good for CVS

[Anonymous Coward]

thanks for the chemistry lesson. so expired aspirin breaks down to salicylic acid and acetic acid and those are bad for you. of course everyone knows this so we just say "expired aspirin is dangerous."

Tell me, when you hear people say "getting hit with a brick is dangerous" - do you yell at them that they don't know physics and then start explaining 1/2mv^2?

are you a fucking socially inept retard of some kind or do you just need an esl class?

and by the way, a little more chemistry for you: salicylic acid is a white powder that doesn't smell. go put some on your dick.

Re:Good for CVS

[budgenator]

You buy the pens before you have an OMG emergency. The pharmacist says "I can order the Mylan Epi-Pen, It's not covered, it will be $699.00 and I can have it here next week or you can get the CVS pen, it's $10.00 out of pocket, and is in stock in case you need it for an emergency over the weekend".

Re:Good for CVS

[budgenator]

Because Schools take away the Kid's drugs and administer any necessary to avoid liability for self-medication error, abuse and sales. Kids take a lot of high abuse potential drugs like amphetamines.

Re:Good for CVS

[Anonymous Coward]

people who say things like you about commonly understood topics are autistic nerds with zero real world experience. us normal people don't need sources and numbers for common sense things. common sense which you lack because you have a brain disease - autism or social anxiety disorder - there is shit wrong with you.

meanwhile, outside of your nerd world, no one gives a shit about reading your page of nothing, and we perfectly well understand that some unnamed unknown bottom-dollar chinese company cannot be trusted like Bayer. you are a loser nerd and pretend to be dense - we ain't got time for your loser ass, and the ridiculous bullshit you say.

let me give you an example you'll understand. you get a new usb keyboard for your gramma. you go to plug it in, and she says - now wait a minute. we should power down the computer first so the electricity doesn't short out. you say - you can just plug it in gramma. she asks you for a keyboard and motherboard manual. and some usb protocol specs - because she's a senile old fool.

you want to find statistics that say random low cost chinese shit is of the same quality as well-known german medicine because "regulation?" go ahead, you autistic moron. I'm certainly not going to bother looking up data that says the chinese crap has worse quality controls than Bayer, because it's true. I'll spend that time fucking girls of caliber that aren't even in you realm of possibilities. idiot.

Re:Good for CVS

[OrangeTide]

Please cite examples. There have been numerous auto injectors on the market with serious problems.

Re:Good for CVS

[OrangeTide]

Yes, $600 gets you 2. that's multiple.

Re:Good for CVS

[dbIII]

So you are willing to risk the generic not being good enough when the difference is $300 vs the life of your child?

Yes. I wrote so above did I not?

what if I told you that 1 time in 10,000 the brand name will make the difference over the generic

I would nod indulgently and wait for you to go away because you clearly know fuckall about standards and testing and have fallen victim to advertising.

If you still say no we will have established a monetary value for the life of your child

Utter bullshit and emotive to boot. What a pathetic little weasel trick to roll out in a situation where lowering yourself to that level gains you nothing of consequence. Works or does not work is what matters not emotive shit, that's the sort of bullshit the naturopath scam artists rely on to get people to try their quack cures. The scam artists say something like "sure, the doctors don't like it but how much is the life of your child worth - you owe it to your child to feed them our grass clippings at a thousand dollars an ounce."

Former CVS pharmacist here

[Anonymous Coward]

I'm now clinical cardiac pharmacist, but I still follow the industry news.

This is a generic for the Adrenaclick, not the Epi-pen. It's the same drug but it not AB rated. It's easily fixable by a call from the filling pharmacist to the prescriber of they write for Epi-pen. We do it all the time.

Re:Former CVS pharmacist here

[DaHat]

I'm the parent of a kid whose doctor has said we should have a pair of Epipens around and had the joy of paying quite a few for them out of pocket for a few year.

I was slightly annoyed when I learned of the Adrenaclick as no one had mentioned it previously at the doctors office, though a quick call to them got the Rx changed to the Adrenaclick which is an order of magnitude cheaper than the Epipen... and a generic version is also welcome news.

Re:Former CVS pharmacist here

[guruevi]

For those of you who have no experience with the medical industry:

AB rating is to indicate the FDA considers this an equivalent substitute. There are currently at least 3 "EpiPen" systems on the market, EpiPen, Adrenaclick and Twinject and I think Auvi-Q is also entering the market again they all are auto-injectors giving 0.3 mg or 0.15 mg of Epinephrine, yet the FDA has rated these 'others' as BX meaning they cannot be interchanged (legally) without a brand new prescription even though they all do the same thing.

So yes, there are alternatives to the EpiPen but the medical industry has made sure that the consumer is not informed when the market breaks.

Re:Former CVS pharmacist here

[Anonymous Coward]

So yes, there are alternatives to the EpiPen but the medical industry has made sure that the consumer is not informed when the market breaks.

The healthcare industry is the antithesis of the free market.

You have consumers who are not and almost cannot be well-informed, often not directly responsible for cost (due to insurance), and in many scenarios, are either incapable of affecting decisions (due to incapacitation) or not in a frame of mind to make rational decisions (due to desperation).

Re:Former CVS pharmacist here

[Anonymous Coward]

I have an EpiPen and the trainer for it. It's relatively straight forward to use an "Adrenaclick" as well, but I can tell just looking at the picture it isn't an equivalent/direct substitute.

The EpiPen is a good design. I feel much more confident I could self-administer, or have a random good samaritan administer my EpiPen in an Emergency than I am about the Adrenaclick.

I have good health insurance, so I got 2x EpiPens for cheap, and my insurance company had to pay ~$500-600. If you want nice things: get good health insurance.

The system is working fine for me. The fact that I get high quality medical care is why the good health insurance is considered an occupational perk. Renegotiating the quality of care you get with shitty health insurance only limits market choices and raises the price of the cheapest health insurance options. If we've learned anything from this ~6 year Obamacare experiment it's that there's no such thing as a free lunch.

Re:Former CVS pharmacist here

[meerling]

Split household, and school, so technically we need at least 3. Insurance only covers the one.

Re:Former CVS pharmacist here

[Anonymous Coward]

We tend to prescribe the trade name drug and add "or generic equivalent". Some prescription forms even come with a pre-printed "or generic equivalent" which the prescriber can cross out if they prefer the brand name variant. Of course academic hospitals and more junior staff tend to use generic drug names, e.g. AZT/3TC instead of Combivir. Private practice doctors tend to be more busy and have no time to write out generic names, so they use trade names, especially if shorter. Sometimes it's just easier to write Augmentin instead of amoxicillin/clavulanic acid Does that sort of thing happen in the US?

Re:Former CVS pharmacist here

[drinkypoo]

I have good health insurance, so I got 2x EpiPens for cheap, and my insurance company had to pay ~$500-600. If you want nice things: get good health insurance.

Nom nom nom this cake is delicious

If we've learned anything from this ~6 year Obamacare experiment it's that there's no such thing as a free lunch.

Romneycare was always intended as a handout to insurance companies.

Re:Former CVS pharmacist here

[budgenator]

No they just click a couple times with the mouse and the Rx either spits out the printer (and is legible) or is sent electronically to the pharmacy of record. If the staff knows how to set up the software, it works well, if not they limp along with the software vendor's defaults. The vendor defaults are usually set up in consultation with industry reps, so generic is extra steps, I suspect there are a product placement deals involved too..

Capitalism is a two edge Soward

[Anonymous Coward]

You raise prices too high and you invite competitors to enter the market.
Well assuming Non-Patent drugs anyway.

Re:Capitalism is a two edge Soward

[Anonymous Coward]

And inviting competition is a bad thing?

Re:Capitalism is a two edge Soward

[meerling]

Not for the consumer

moral capitalism

[Anonymous Coward]

not autocratic totalitarian despotic dictatoral Moral capitalism as done by The Cathaholic Crutch.

actual capitalism optimizes competition and price to assure future purchases and transactions, not destroy competition or harm customers which is bad reciprocity.

Re:moral capitalism

[PopeRatzo]

actual capitalism optimizes competition and price to assure future purchases and transactions

You better look up the definition of capitalism. It has nothing at all to do with "optimizing competition". It's about the aggregate of capital, nothing more. Everything else is just marketing.

Good first step...

[LaughingRadish]

This is a good first step to reducing excessive prices on lifesaving / life-sustaining drugs. The next is to tackle the monopolies that exist for insulin, particularly the long-acting variety. There is only one "legal" manufacturer of Lantus in the US. A single vial costs on the open market is around $135.

Re:Good first step...

[Anonymous Coward]

see basaglar

Re:Good first step...

[Anonymous Coward]

Insulin helps your body process excess glucose. Talk about a first world problem. Eat a carrot fatty.

Re: Good first step...

[Anonymous Coward]

Or simply die. We don't need ugly balls o'lard trundling around and stinking the place up with the foul stench of stale sweat exhuding from their flaccid bodies.

Re:Good first step...

[LaughingRadish]

My my... you have strong opinions about other people's diseases...

Re:Good first step...

[Major Blud]

Or you could try reading up on what Type 1 Diabetes actually is.
https://en.wikipedia.org/wiki/...

Re:Good first step...

[Major Blud]

I'm Type 1, and of course I don't know your' particular situation, but once I got an insulin pump, I no longer needed Lantus. This is because the pump gives you small doses of fast acting insulin through out the day, 24x7 (Humulog or Novolog).

The pump has been one of the greatest improvements in my quality of life.

Re:Good first step...

[LaughingRadish]

Not everyone can afford cybernetic upgrades like that.

Ready...

[guygo]

I see Mylan's PR people have their "I find the Adrenaclick impossible to use" shills ready to go. We can expect them to spend millions on trying to discredit the competitor's much cheaper alternative. Heaven forfend they spend any of that money reducing the price of their own product.

Re:Ready...

[Onuma]

I wouldn't put it past them.

Here are 3 quick demonstrations. They're literally all as easy as the next: unsheath the autoinjector, remove safety caps, depress the needle into the thigh for ~5-10 seconds, then call 911.

https://youtu.be/GOp1Rb5m04o?t...

You don't know what a free market is, do you?

[cirby]

You see, a "free market" is actually free, not controlled by government-run bureaucracies that make it very difficult for medical device manufacturers to produce something that ISN'T covered by patents any more.

You know, like epinephrine injectors.

Re:You don't know what a free market is, do you?

[Anonymous Coward]

It's a bitch when you have to show that your product actually works and doesn't kill people.

Re:You don't know what a free market is, do you?

[Ol Olsoc]

You see, a "free market" is actually free, not controlled by government-run bureaucracies that make it very difficult for medical device manufacturers to produce something that ISN'T covered by patents any more.

You know, like epinephrine injectors.

But I thought that America was deep in the throes of Regulations that force prices to be high.

So if we are over regulated, yet CVS has managed to bring the price down, then I don't know that a free market argument applies, because FDA, O'Blama, and Franklin Roosevelt.

After all - if a free market doesn't exist, how can it work it's magic?

Re:You don't know what a free market is, do you?

[HornWumpus]

It's 'free enough', absolutes don't exist outside the minds of theoreticians.

Re:You don't know what a free market is, do you?

[Ol Olsoc]

It's 'free enough', absolutes don't exist outside the minds of theoreticians.

And ideologues.

Re:You don't know what a free market is, do you?

[knightghost]

Speaking of "free enough" - where do I get the ones for $9.99? I'd like to add one to my emergency kit for whoever needs it.

Re:You don't know what a free market is, do you?

[Daemonik]

Nobody who actually wants to run a company would ever settle for a system without patents, copyrights or some form of IP protection, for the simple fact that it's much much cheaper to duplicate than to innovate.

Now charities, government funded universities, they could thrive in your imaginary totally free market where there are no patents and all ideals are open.

Re:You don't know what a free market is, do you?

[PopeRatzo]

Nobody who actually wants to run a company would ever settle for a system without patents, copyrights or some form of IP protection

Companies existed long before patents and IP. Almost two centuries, in fact.

Re:You don't know what a free market is, do you?

[Anonymous Coward]

Nobody who actually wants to run a company would ever settle for a system without patents, copyrights or some form of IP protection, for the simple fact that it's much much cheaper to duplicate than to innovate.

The fashion industry says hi.

Or, if you're into history, everyone else 250 years ago.

Re:You don't know what a free market is, do you?

[Tranzistors]

Indeed they did, and they protected their “rights” with guilds, gunboats and monopoly rights from monarchs. I personally would not want to have FedEx with private army.

Re:You don't know what a free market is, do you?

[PopeRatzo]

Indeed they did, and they protected their “rights” with guilds, gunboats and monopoly rights from monarchs.

So, what you're saying is, corporations have always required government intervention and labor organization to succeed. Duly noted.

At least now we can dispense with the notion that there has ever been anything like a "free market".

Re:You don't know what a free market is, do you?

[Required Snark]

You are too young to for this to be part of your personal experience, but there once was a drug called Thalidomide. It was sold for morning sickness and caused severe birth defects. Thousands of infants died and tens of thousands were born with deformed limbs. This was in the mid 1950's and caused a massive change in how drugs were tested. Thalidomide is still used, but not by pregnant women.

More recently there are significant problems with metal on metal joint replacements. For some designs the failure rate is 75% to 100%. And this was after FDA approval was granted.

So is the requirement for government approval the "bureaucracy" you are talking about? If so, I'm sure you can find somewhere in the world where you can get a completely unregulated major medical procedure, say involving surgery. Before you go, just leave a contact address so we know where to send the condolences for your funeral. I, at least, would consider your demise to be suicide.

Re:You don't know what a free market is, do you?

[Tranzistors]

So, what you're saying is, corporations have always required government intervention and labor organization to succeed.

I would like to agree, but I'm not sure what you mean by “government intervention”. Do you consider modern law enforcement as government intervention? For example, guilds could be seen as [city] government tool to protect industry and keep prices high, but if there is no [formal] government, craftsmen would most likely make their own Mafia style organization, with burning down of competition. Would this type of labor organization be more free?

At least now we can dispense with the notion that there has ever been anything like a "free market".

It depends. If we go by wikipedia article on free market, global stock and commodities markets are pretty free. When it comes to every-day stuff we buy, asymmetry of “market power, bargaining power and information” makes it nigh impossible to have a truly “free market”, and ofttimes governments try to make markets more free than they naturally would.

P.S. I forgot to add trade secrets.

Re:You don't know what a free market is, do you?

[aevan]

Wouldn't law enforcement be government intervention, by definition of 'whose laws are being enforced'?

Re:You don't know what a free market is, do you?

[Tranzistors]

Perhaps PopeRatzo meant it as a selective and arbitrary intervention.

Re:You don't know what a free market is, do you?

[Maxo-Texas]

They expire.

https://www.washingtonpost.com...

Looks like the 18 months is aggressive tho. Might depend on storage conditions too.

Re:You don't know what a free market is, do you?

[silentcoder]

So does the cooking industry. You can't get patents or copyrights on a recipe. You can trademark a brand but you can't stop anybody else from making the exact same product.

Re:You don't know what a free market is, do you?

[meerling]

Among other conditions. A free market is essentially a utopian theory for economics, totally unrealistic despite it being desirable.
It also assumes there are no real barriers to market entry so anyone can decide to market something if they think they can do it better.
That is so far from reality, it's virtually insane.
Anyway, it's a neat idea, but it's not a viable one.

Re:You don't know what a free market is, do you?

[TheRaven64]

Patents were already established by the industrial revolution (indeed Watt's extension of steam engine patents was the first documented serious abuse of the patent system). Anything before that is pretty much irrelevant to an industrial economy.

Re:You don't know what a free market is, do you?

[Anonymous Coward]

And in that free market there'd be little motivation to spend hundreds of millions on drug development (unless you have a wealthy charitable benefactor) because you couldn't recoup the cost through sales as any knock-off shop could duplicate your product and sell it cheaper because they wouldn't have any R&D costs to recuperate.

There has never been a "free market" by the theoretical definition you wish to discuss/promote. There have always been protectionist tariffs, trade restrictions, registration/authorisation mechanisms, guilds, licenses or whatever; go back before government and you're market was controlled by whichever tribal leader or warlord was dominant at the time based on their personal preferences.

Re:You don't know what a free market is, do you?

[Anonymous Coward]

Fashions can have design patents, idiot.

Re:You don't know what a free market is, do you?

[Anonymous Coward]

You need a qualifying patient - basically someone who has a condition severe enough to justify it.

Re:You don't know what a free market is, do you?

[edtice1559]

I am not a doctor and I would never even attempt to give medical advice. However, it seems that many "expired" drugs work just fine. An emergency kit with an expired epinephrine injector would probably be better than one without. More research is probably warranted. Until this announcement, there were people doing just that... trying to figure out how long these could really be used. You can be pretty sure that poorer people weren't replacing these when they wore out. Schools and health providers on the other hand couldn't possibly use something expired or even give it away which is a shame. There's probably a lot of waste here. These are really an emergency supply and an emergency kit seems to be where they belong. Nothing else in an emergency kit expires so quickly.

Re:You don't know what a free market is, do you?

[Anonymous Coward]

Given that corporations are created by government charter, why should this be a surprise? There's absolutely nothing inherent in free-market capitalism that requires the corporate form exist.

Re:You don't know what a free market is, do you?

[HornWumpus]

Idealogues are a subset of theoreticians. They are just very emotionally attached to their pet theory.

Re:You don't know what a free market is, do you?

[networkBoy]

generally (and the exceptions are a bitch) an expired drug is safe but its efficacy is reduced. For some products that rate of reduction is low and an expired product can be good for a year or two after the date (Liquamycin for example), for other products the rate of decline is non linear and fast, so are only good a couple months past date with any real efficacy (Covexin®-8. CDT comes to mind).

Epi seems to be between the two, within some limits:

EpiPen's shelf life has been limited by the chemistry of the drug inside it. Epinephrine is an old and cheap medication, but it's also notoriously finicky. If exposed to light, heat or air, it can degrade, turning rust colored.
The FDA-approved label warns that if the liquid in the pen is discolored, it should be discarded: "Epinephrine solution deteriorates rapidly on exposure to air or light, turning pink from oxidation to adrenochrome and brown from the formation of melanin."

Great! so there's a way to tell, separate from the date!

But what about an expired EpiPen that looks perfectly normal?

The little published data that exists shows that the drug degrades over time -- and color is not an accurate way to gauge whether the epinephrine inside is still good.

well crap, maybe not.

One study, published in the Journal of Allergy and Clinical Immunology in 2000, examined EpiPens one to 90 months after the expiration date. Most were not discolored, but the epinephrine content decreased over time. The study stated that it was best to use EpiPens that had not expired, but found that the pens contained at least two-thirds of the intended dose up to a year after expiration. Even a sub-optimal dose could be better than nothing in a life-or-death situation, the authors concluded.

So...
Looks like if stored in *ideal* conditions the pen will last more than 18 months, but under likely real-world conditions 18 months is it.
FWIW, elsewhere I found that the manufacturer had targeted 27 months, but data only supported 19 months, they went with 18. That's not a large guard band.

Re:You don't know what a free market is, do you?

[edtice1559]

Wish I could mod this up.

Re:You don't know what a free market is, do you?

[weeboo0104]

Yeah, 70 years ago in Germany you did NOT want guys in brown shirts knocking on your door!

Re:You don't know what a free market is, do you?

[Anonymous Cow Ward]

A "free market" is not one with no government interference at all. It is one where buyers and sellers are allowed to set prices without government interference.

Re:You don't know what a free market is, do you?

[HornWumpus]

Adrenochrome?

Fear and Loathing...don't take too much.

Re:You don't know what a free market is, do you?

[Anonymous Coward]

Of course, said free market is also free to provide medical devices that fail, do not do what they claim, or just generally do more harm than good. Regulations exist for a reason. As much of a problem as regulatory capture can be, don't throw the baby out with the bathwater.

Re:You don't know what a free market is, do you?

[Archangel Michael]

Its a bitch when you bribe enough people, run enough tests to get a drug that kills people through the system, and there is almost no recourse by the public to sue the government for lack of proper due diligence. How many drugs have been recalled because they were worse than the diseases they were trying to solve.

I'd much rather have placebo effect snake oil than harmful Big Pharma drugs that pass FDA approval. How about you?

Re:You don't know what a free market is, do you?

[Anonymous Coward]

"It's a bitch when you have to show that your product actually works and doesn't kill people." ... except that epinephrine has been proven safe and effective over 100 years ago. ... and yes, because you can harm people you should have to prove your manufacturing methods (Asceptic technique, quality control)... but how much should that barrier cost? For example-- you should have to prove you're not going to kill people while you're behind the wheel of a car-- but if driver's training & license ran $50K per person-- would that be effective for society? Or would that simply limit the market for people who can drive cars-- and what would that do to Taxi and Uber rates?

Re:You don't know what a free market is, do you?

[Anonymous Coward]

Regulations are too damn high in cost. This wasn't a problem until one of the MFGs noticed they had a monopoly and could gouge the consumer.

Fact is, even at $100, it's more than 100x cost of materials to manufacture (I used to work in pharmacy and bought USP Epinephrine bulk). You only think that $100 is a deal because someone else charged $600 for it (when BOTH are wrong).

Re:You don't know what a free market is, do you?

[PCM2]

You can't get patents or copyrights on a recipe.

I think the issues are a little more complex than this. No copyrights on a recipe: sort of right. You cannot copyright a simple list of ingredients or basic instructions explaining how to put them together. Cookbooks, on the other hand, which include cute or clever language, photos of meals and so on are certainly copyrightable.

I believe you may be able to get a patent on a recipe. The reason companies don't bother -- why Coca-Cola has never patented its secret formula, for example -- is because it would be pointless, because patents are public. As soon as Coca-Cola patented its formula, everybody in the world would know exactly how it was made, and it would be trivial to create taste-alike products. Instead, Coca-Cola maintains its formula as a trade secret and does not rely on government protections such as patents.

Re:You don't know what a free market is, do you?

[Anonymous Coward]

Right? It's like when people think they saved money because their insurance paid for part of the $inflated_cost of $hospital_item, when they are dirt cheap to produce. More chargemasters need to be killed methinks.

Re:You don't know what a free market is, do you?

[Anonymous Coward]

The injuries and fatalities of drugs of mistakenly accepted drugs/procedures are obvious and clear from the data and pictures. What is far less clear is all those who might have been cured had treatments entered the market earlier. It is fundamentally a statistical issue - if you set a higher threshold to decide whether a drug is safe/effective, you remove the chances of a a false positive treatment assessment. On the other hand you also increase the probability of a false negative assessment of the treatment or have to (generally by quite a lot) increase the size of your study. This means that the price of preventing more harm from treatments is causing (on average) more harm to those from whom you are withholding the treatment and/or charging those who eventually receive the treatment more to cover the increased costs of testing. It is possible that we are in the perfect spot, under-regulated, or over-regulated, but the nature of incentives for regulators due to the relative visibility of the two types of errors is likely to push us toward being overly conservative in approving treatments.

Re:You don't know what a free market is, do you?

[silentcoder]

>I think the issues are a little more complex than this. No copyrights on a recipe: sort of right. You cannot copyright a simple list of ingredients or basic instructions explaining how to put them together. Cookbooks, on the other hand, which include cute or clever language, photos of meals and so on are certainly copyrightable.

Yes, you can copyright a cookbook - but not the recipes inside. I can copy down any recipe in a cookbook and give it to a friend without violating a law, the recipes are not copyrightable.

>I believe you may be able to get a patent on a recipe.

Nope. Under the Berne convention certain classes of goods known as "necessities for life" cannot, in any signatory country, qualify for any of the laws that the Berne convention covers (Trademarks, Copyright, Patents). Clothing and Food (which includes recipes) both fall under this exception. That's why fashion designs cannot get IP protection. You can trademark your logo, but not the design.

Re: You don't know what a free market is, do you?

[Anonymous Coward]

The high price epipen had a reliable and fool proof design, FDA approval, and a history of performance that supports these claims.

The vendor has a history of ...

We should now pass a law...

[Anonymous Coward]

...where Mylan MUST keep their price st $600.

Capitalism works, SLOWLY

[gurps_npc]

This is strong evidence that capitalism does work, eventually.

The problem is it takes a lot of time, particularly when government regulations slow things down - especially when those regulations are important safety precautions that should not be removed.

Re:Capitalism works, SLOWLY

[Anonymous Coward]

All that it proves is that the government regulations slowed down a possible alternative for around 10 years, while forcing the entry price of the alternative to be seen as amazing even though it's the same price as it was before someone evil took it over.

There's nothing here that suggests "those regulations are important safety precautions that should not be removed." I am certain that some of them are important, but I am just as certain that many are useless and obstructive to enrich companies like Mylan thanks to their lobbyists.

Re:Capitalism works, SLOWLY

[Narcocide]

You missed the point entirely. It wasn't regulations that slowed down competition here. It was an uncontested monopoly; i.e., the exact opposite of a "free market."

Re:Capitalism works, SLOWLY

[gurps_npc]

Psst. I have here a generic "EppiPen". Just inject it into your muscle whenever you have an allergic reaction. Ignore the words "Heroin", can't you see it's been crossed out?

In this case, both the drug and the delivery system are extremely risky. The drug can cause a heart attack and the delivery system has to work through clothing when used by totally panicked, almost untrained people.

Re:Capitalism works, SLOWLY

[Anonymous Coward]

Uncontested monopolies are artificially created in the pharmaceutical industry because of regulations that slow entry..

Re:Capitalism works, SLOWLY

[Anonymous Coward]

The delivery system can be copied because it's not patented anymore and the drug already has a generic form.

Re:Capitalism works, SLOWLY

[Actually, I do RTFA]

This is strong evidence that capitalism does work, eventually.

It depends a lot on what you mean by "works". That things eventually get better? Sure, but things also economically got better under feudalism. Hell, quality of life, materially, even improved in Soviet Russia over time. That's a very low bar.

On the other hand, if you compare this to the epipen in countries that do not let capitalism run free reign over health care, this "supercheap" solution is still more expensive than in these countries. In Canda, for exmaple, it's like 30% cheaper.

Re:Capitalism works, SLOWLY

[SuricouRaven]

Totally panicked, completely untrained people. They are not just for use by the patient, but by bystanders rendering first aid.

I work at a school, so I get the circular emails informing all staff of students with special medical needs. These include a notice as to which students carry an epi-pen, just in case.

Re:Capitalism works, SLOWLY

[Megol]

Autoinjectors aren't new and they all work the same: remove the safety mechanism and jam the active end into a large muscle.

Re:Capitalism works, SLOWLY

[meerling]

For some stupid zero tolerance antidrug reason, the schools around here won't let students carry their required medicines. Instead, it has to be given to the office, who keeps it the whole school year, only letting it be retrieved for emergencies. (There are so many problems with that I'd like to see the idiot that come up with it get a nice allergic reaction to something and find out his meds are at least and extra 10 minutes away, and double his cost for them since he has to have a complete second set.)

Re:Capitalism works, SLOWLY

[maz2331]

The key factor isn't regulations vs. free-for-all, but making sure that the regulations are as simple to comply with as possible without compromising the stated goal, and making the bureaucracy move faster and with less BS paperwork that serves no purpose other than checking off a box. Additionally, it is really important to understand that we currently have a condition where multiple agencies at both Federal and State levels promulgate regulations that are not coordinated over the same subject, and do make the rules such that it is not possible to comply with all of them at the same time - comply with Rule X and violate Rule Z, for example. That ends up having to be resolved in court after millions of dollars in litigation and often criminal liability, and makes the environment such that only those players with deep enough pockets can enter the market, and all others are locked out.

A free market doesn't have patents

[rsilvergun]

As the saying goes: We've already established what you are. Now we're just negotiating.

Never thought I would say it

[Anonymous Coward]

Yay for a CVS... good to see them doing something for the good of the peoples!!

What lesson is that?

[rsilvergun]

they made millions while waiting for CVS to put this out. So what lesson? Maybe charge more?

Re:What lesson is that?

[HornWumpus]

The lesson to smart monopolists is 'don't charge the full tilt monopoly price unless you want to attract competition'.

Had their excess profit been less than the short term amortized cost of entering the market, they could have milked it for decades.

Charging more would have drawn competition faster.

Re:What lesson is that?

[Motherfucking Shit]

Had their excess profit been less than the short term amortized cost of entering the market, they could have milked it for decades.

American capitalism hasn't thought that far forward in a long time. The CEO has an EPS target to meet so his golden parachute kicks in. Next quarter is someone else's problem, and the next decade might as well not even exist.

Re:What lesson is that?

[swb]

It wouldn't surprise me if Mylan hadn't already modeled pricing pretty extensively and what they could get away with. They had worked pretty extensively to get mandates for stocking Epipens implemented, thus also forcibly expanding the market of who had to buy them as well.

I'm guessing that for many large insurance plans they were willing to negotiate away most of the price increases, too. Drug "list" prices are about as meaningful as most list prices, fantasy numbers that nobody with any negotiating power actually pays.

I wonder if the problem wasn't the price, really, but that since Martin Shkreli created a public awareness of off-patent drug price increases the press and public was primed to squeal about any significant price increase in the same broad category of drugs. Mylan just happened to hit the bad PR trifecta.

How many other generic drugs now have a single supplier and high prices unrelated to Shrkreli or Mylan, but we just haven't heard about them because they haven't hit critical mass?

Re:What lesson is that?

[budgenator]

The Bonuses and Interest on the big Bonuses for the last 4 years is bigger the the smaller bonuses spread out over decades.

"Super Cheap"?

[0100010001010011]

Still $55/pop. I would have gone with 'cheaper'. "Super Cheap" is a bit of hyperbole.

FYI: Epinephrine is $4.79/vial.

Re:"Super Cheap"?

[HornWumpus]

Roll your own and post the design on 'Hackaday'.

Re:"Super Cheap"?

[Anonymous Coward]

From what I've read, they're actually about the same price as Epipens were before the market crash a decade ago. This is basically another take on the time-honored tradition of jacking up the price before YUUGE XX% DISCOUNT SALEZ!

Re:"Super Cheap"?

[guruevi]

With the coupon they're $9.99 and no company is going to sell this stuff under the cost of production. The only reason they're still $100+ is because the original EpiPen is $600 and because they have no competition. Soon the EpiPen will be $100 too, at CVS at least, but until it's generally available for $100, you won't see the price drop.

Re:"Super Cheap"?

[guruevi]

Someone already did: https://fourthievesvinegar.org...

Re:"Super Cheap"?

[Imrik]

It's possible that they're getting compensation in some form for offering the coupon, allowing them to have the customer pay less than the full cost.

Re:"Super Cheap"?

[avandesande]

The are 25$ in Europe

Re:"Super Cheap"?

[Dr_Barnowl]

The UK National Health Services gets them for about $35.

Adrenaline / epinephrine - fan out the section at the bottom "Intramuscular injection for self administration".

Re:"Super Cheap"?

[meerling]

It's only hyperbole if you consider the current super expensive price a normal price.

Re:"Super Cheap"?

[Overzeetop]

Yep - and as a kid, we always had a vial around for veterinary use (for the animals). It probably also may have saved my father when he got stung by a bee and had an allergic reaction (none of us had a known allergy that would have caused us to have an epipen around). But, you know, it's too dangerous to have the average human know how to read a label, choose a medication dose (to within about factor of 3 - which is the "safe" range for epinephrine) and give a proper IM injection.

Re:"Super Cheap"?

[tlhIngan]

With the coupon they're $9.99 and no company is going to sell this stuff under the cost of production. The only reason they're still $100+ is because the original EpiPen is $600 and because they have no competition. Soon the EpiPen will be $100 too, at CVS at least, but until it's generally available for $100, you won't see the price drop.

The cost of the drug inside is under $1. The autoinjector is mass produced and probably costs another $1 to make.

Epi Pens were under $150 each before Mylan saw they had a monopoly and jacked the price up like many other drug companies. Because you cannot substitute other autoinjectors in a prescription, if you are prescribed an epi-pen (and who isn't, they're well known) you can only get one.

They can sell the things for $10 and still make an easy profit because it doesn't cost very much to make. The drug's generic, and the rest of it is plastic.

Re:"Super Cheap"?

[Lehk228]

the $50 is for the device which stores the epinephrine durably enough to toss in a purse or duffle bag, and which can be depended upon to dispense the right amount when you are choking on your own throat and have to grab it and shove the business end into your leg.

Originally was only 100.00

[Anonymous Coward]

So big whoop.

Super Cheap?

[Onuma]

I get that it is relatively inexpensive when compared to the EpiPen...but is a $110 medication with a 1-year shelf life "super cheap"? That's at least $220 per year -- because you always need a backup, should the first potentially life-saving drug fail.

Re:Super Cheap?

[Lumpy]

Why do you need three backups? They are $110 for a TWO PACK.

and their shelf life are more than 1 year.

Re:Super Cheap?

[Anonymous Coward]

This is for a pack of two (that is, backup is included)

Re:Super Cheap?

[PRMan]

I heard the shelf-life was 3 years, but don't quote me on that (especially if you need it to survive).

Re:Super Cheap?

[HornWumpus]

Willing to bet it depends on storage conditions.

They make smart labels for temperature sensitive drugs that integrate temperature over time (some chemically, some electronically) and turn red when it's no longer 'good'.

Re:Super Cheap?

[Onuma]

Because you need to have two with you at any given time. Keep a 2-pack in the house, keep a 2-pack in your briefcase, or diaper bag, or whatever you take around with you (or whatever goes with your children, as applicable).

If the shelf life is >1 year, I simply missed that part. It does not state on the official website, so I'm going off the directions on my child's EpiPen Jr. The drug is the same, but the solution & structure of the autoinjector may give it significantly different shelf life.

Re:Super Cheap?

[Onuma]

The official Adrenaclick website does not indicate. The EpiPens I already have showed a 1-year shelf life, for that particular production run / lot #, at least. I'm assuming (possibly wrongly) that there is a similar shelf life between EpiPen and other adrenaline autoinjectors.

Re:Super Cheap?

[Anonymous Coward]

Why do you need a 2-pack with you at all times? What are the odds that two people will simultaneously have an allergic reaction?

Re:Super Cheap?

[meerling]

The ones we've been getting from the pharmacy is around a year shelf life.
Yeah, and we need an unopened pack for school.
You want to have a spare at home.
My and her mother are separated, so that's actually a total of 3 packs for reasonable safety.

Re: Super Cheap?

[Anonymous Coward]

It kind of seems like your genes just need to die off.

Re:Super Cheap?

[Onuma]

They come in two-packs because one autoinjector may fail...at which point, you're fucked. It's not necessarily for a separate individual to use simultaneously, or at a later time. There is also a chance that you can receive instruction (from an EMT / emergency dispatcher / physician, as examples) to provide a second dose of epinephrine to the patient if the first wears off -- 15 minutes may not be enough relief from anaphylaxis for medical professionals to arrive, especially in more remote locations.

Now let's fix the stupid laws....

[Lumpy]

That make it so you have to have a prescription to buy them in the USA.
Canada they are over the counter and I buy them for my first aid Kit. it is 100% stupid to not allow anyone to buy them and make sure they can help to save lives.

Re:Now let's fix the stupid laws....

[zenlessyank]

We have THOUSANDS of stupid laws here. It's like swatting at flies at the fecal factory.

Re:Now let's fix the stupid laws....

[GerryGilmore]

Ta-da! While everyone wants to get rid of the EPA, etc., how about we get rid of the DEA and rein in some of the excessive bullshit in the legal (not regulatory only) system.

Re: Now let's fix the stupid laws....

[Anonymous Coward]

No, we can't let the druggies win! Nancy Reagan fought to protect us from marijuana legalization, and I won't stand for decriminalization either! We must protecg her legacy.

Meanwhile, a few million prescription pain pills to a town of 500 people is totally legit.

Re:Now let's fix the stupid laws....

[avandesande]

Even better, make it so it is legal for people in the US to buy from Canada. Than we will have a 'free market'.

Re:Now let's fix the stupid laws....

[Anonymous Coward]

Republicans just voted this down.

Re:Now let's fix the stupid laws....

[silentcoder]

You have a fecal factory ?

And they say American manufacturing is dead. Then again, America has always been, and remains, the world's number one manufacturer of bullshit.

Re:Now let's fix the stupid laws....

[silentcoder]

And 13 democrats helped them do it (not least Cory Booker- now there's a Dino if ever I saw one).

Please punish those democrats in the midterms - give their seats to actual progressives. It's EXPECTED that republicans will fuck the little guy to enrich corporations, when democrats go along with it - that's a seriously flagrant betrayal of the people who voted them into office.

Re:Now let's fix the stupid laws....

[greatpatton]

They have weird regulation in the US. I forgot my contact lenses at home, and wanted to buy some over the counter (as you can do in most of Europe/World). To my great surprise, I was told than in the US it was impossible to buy contact lenses without a prescription -> (me banging me head against a wall). Finished my US stays with glasses. On the other side, you can go to a supermarket and buy paracetamol that can kill you easily if you are not careful.

Re:Now let's fix the stupid laws....

[zenlessyank]

I don't own you yet. How can you hear with all those flies buzzing?

Re:Now let's fix the stupid laws....

[Anonymous Coward]

I think you mean FDA.
Google "Thalidomide".
And no that is not the Only Drug the FDA rejected or rescinded approval.
Buy Chinese and India made drugs and hope they are not contaminated or have the active ingrediant.

So not Ta-Da

Re:Now let's fix the stupid laws....

[Lumpy]

in the USA it's not about protecting people. It's all about protecting profits for industries.

Yet another monolithic mono-paragraph "summary"

[QuietLagoon]

Geez, when are the /. editors going to be real editors? This isn't pretend here. Some folk take this site seriously, and feel an attachment to this site. Can we bump up the curating quality a notch or two... Puuuuuuuullllllleeeeeeaaaaasssssseeeeeeeee?

Still Expensive

[Anonymous Coward]

The price of $109.99 would still be stretch for some people. I am not sure how much the medication cost, but I would think the injector is cheap to produce in mass production. It seems a price of about $25 for two would be reasonable and still enable a company to make a good profit.

Re:Still Expensive

[raburton]

UK NHS drug tariff price for genuine Epi-Pen £52.90 for a pair (that's approx. what the NHS actually pays), actual cost to patient £8.40 (standard NHS prescription charge, exemptions apply for those on benefits, etc.) The NHS may be systematically being dismantled by the government and the media, and it's hated by Americans because they have been told it's socialist and pushed propaganda to support their country's alternative view on healthcare, and yes it does have real problems too (most of which could be solved by proper funding, but see my first point), but this is an example of why a proper healthcare system is a good thing to have. We are going to miss it in another 10 years when it's gone and find ourselves in the mess America is in.

Re:Still Expensive

[laughing_badger]

What struck me recently is that the oft-repeated claim that the UK has 'death panels' deciding who lives and dies (essentially NICE deciding whether a drug is effective enough for the NHS to provide) is currently more accurately applied to describe the Senate dismantling the ACA.

Re:Still Expensive

[moeinvt]

"Death Panel" is an inflammatory term, but it has a basis in fact. Any government-run medical system must limit the amount of goods and services provided. Otherwise, costs would quickly spiral out of control. People in such systems are put on wait lists and people on wait lists sometimes die before getting the services they need. Despite its many faults, the USA healthcare system can typically(except for transplants & such) administer goods and services "on demand".
Anyone who believes that a government healthcare system in the USA means "Everything stays the same except for prices" is utterly naive.

Government healthcare means that those in charge must make decisions to ration services and those decisions WILL result in the deaths of some people in the system. Is that a "death panel"? IMO, that term conjures up the wrong image, but I can see why people use it.

Re:Still Expensive

[Anonymous Coward]

We are going to miss [the NHS] in another 10 years when it's gone and find ourselves in the mess America is in.

Yes, but you'll be free!

Re:Still Expensive

[Anonymous Coward]

£52.90 is 65USD who cares what the UK deductible is.
$100 is a lot closer.

"$110 is still way too expensive. Syringe = $0.05. Epinephrine = $2."
The Building, the Workers , the Machines, the NRE, FDA Approval,, The Insurance, the Taxes. Labels, Packaging, ect.
Oh and Profit
2.05 for some of the raw material means nothing. That is like saying the cost of the Iron ore used to make a car.

Re:Still Expensive

[Bookworm09]

Any government-run medical system must limit the amount of goods and services provided. Otherwise, costs would quickly spiral out of control.

...

Government healthcare means that those in charge must make decisions to ration services and those decisions WILL result in the deaths of some people in the system. Is that a "death panel"? IMO, that term conjures up the wrong image, but I can see why people use it.

"Any medical system must limit the amount of goods and services provided. Otherwise, costs would quickly spiral out of control."

FTFY. All scarce resoources are rationed. If you think that medical goods and services aren't rationed in a private healthcare system, you are mistaken. The conversation is (or at least, should be) how to distribute those scarce resources in the "best" way possible. The problem is that right now, everybody has their own definition of what "best" means.

Free markewt is cool

[QuietLagoon]

However (and you had to know there would be an however...) what about the quality of the drugs? If the drugs are made in China, I have serious quality concerns. https://www.google.com/search?...

Re:Free markewt is cool

[avandesande]

That's my problem.

In 3... 2... 1...

[fahrbot-bot]

Trump takes credit for this.

Ha, just kidding, one of his biggest campaign contributors, John Paulson, runs a hedge fund heavily invested in Mylan.

Re:In 3... 2... 1...

[Anonymous Coward]

Is that information current, or did they sell off before this announcement?

Re:In 3... 2... 1...

[Dr_Barnowl]

Why would campaign contributors have to divest themselves?

Re:In 3... 2... 1...

[Anonymous Coward]

I suppose the fact that Mylan contributed to the Clinton Foundation was just a clerical error, eh?

www.snopes.com/mylan-ceo-clinton-foundation/

$110 for two of these is NOT cheap

[Anonymous Coward]

These things can be made VERY cheaply according to recent reports I have read. CVS could likely sell these for $50 or $60 and still make plenty of money.

I'm betting

[Anonymous Coward]

Get ready for a "safety" recall in 3....2.....1..... Well, they might not try it this time seeing as how the amount of controversy/scrutiny would be immense. Remember the reason why Mylan had such unequivocal control of the market is that their competitors were all pulled/blocked from the market (one via a safety recall, one via FDA rejection), it could have just been a "lucky" coincidence I suppose, or Mylan might have clogged the gears with a few well placed bundles of cash.

And mathematicians, including

[raymorris]

Including programmers

Re:And mathematicians, including

[Ol Olsoc]

Including programmers

The problem with the free market, and lassaize-faire capitalism is that it is destroyed by the first group that has major success. Becuse the greed that fuels the market can become very destructive as people with pathological levels of it inevitably take over. And the simplistic early agriculture type arguments for it just don't work in a highy technical and mechanized world. You gotta have some brakes on any "ism". And the reason is, ideology doesn't work at all. Idealogues end up going insane. Its how we have people arguing that we have to put the overpaid American worker out of a job, ignoring that laid off people don't buy the shit that's being produced. Capitalism with some restraints? Now that works a trick.

Re:And mathematicians, including

[Solandri]

The problem with the free market, and lassaize-faire capitalism is that it is destroyed by the first group that has major success. Becuse the greed that fuels the market can become very destructive as people with pathological levels of it inevitably take over. And the simplistic early agriculture type arguments for it just don't work in a highy technical and mechanized world.

There are so many examples which disprove this that I'm amazed it was modded up: IBM PC, Compaq, Apple iPhone, 3dfx, Blackberry, Palm Pilot, Nokia, GeoCities, Myspace, Wordperfect, Lotus, Silicon Graphics, Kodak, Blockbuster, Sony Walkman, Sears, Pan Am, Schwinn, Motorola, Sun, DEC, Yahoo, Xerox copiers, Nintendo (except they managed to claw their way back with the Wii).

All of these were market leaders who in many cases once owned 80% or more of their respective markets, til they were out-competed and were replaced as king of the hill. Contrary to what you claim, it's harder to maintain a dominant market position in a highly technical and mechanized world. The rapid pace of technological progress means it's very easy to fall behind if you misstep (Yahoo, Sony, Pan Am, Blockbuster), or get lazy (Xerox, Kodak, Myspace, Blackberry), or get out-maneuvered (Nintendo - both ways, WordPerfect, Lotus, Apple iPhone, IBM PC).

The free market works most of the time. Monopolies are the exception, not the norm, and I'm fine with bashing those with government regulation when they happen. Believing that monopolies are inevitable and thus everything must be regulated, is just as foolish as believing everything will work just fine if there is no regulation.

Re:And mathematicians, including

[Zack63]

This is not even a coherent thought. 

Re:And mathematicians, including

[Anonymous Coward]

The free market works most of the time. Monopolies are the exception, not the norm, and I'm fine with bashing those with government regulation when they happen. Believing that monopolies are inevitable and thus everything must be regulated, is just as foolish as believing everything will work just fine if there is no regulation.

But monopolies are inevitable. The funny thing about Capitalism and free markets is that the participants are incentivised to destroy the system. Free markets require competition, free information, and low cost of entry, among other things. Individual businesses are incentivised to crush the competition, keep information secret, and erect barriers to entry. Thus Capitalism contains the seeds of it's own destruction and must be saved from itself.

Re:And mathematicians, including

[Anonymous Coward]

Damn, that was very insightful.

Re:And mathematicians, including

[Anonymous Coward]

Funny thing about all those examples: they happened after antitrust laws were enacted.

It's very, very hard to out-compete an unregulated monopoly, because they can play pricing games that no competitor can survive. Try selling your copiers when Xerox is selling theirs below cost simply to drive you out of business. The only way to unseat an unregulated monopoly is to have massive cash reserves, so it's effectively reserved for companies with a very strong presence in other markets - perhaps a monopoly, even.

Re:And mathematicians, including

[HornWumpus]

Nobody except Marx has even claimed that monopolies are inevitable. He was wrong about every prediction he made. Capitalism should be down to zero profit by now, if you believe that drunken idiot.

Less Karl, more Adam would do you good.

Re: And mathematicians, including

[Anonymous Coward]

I'll join that claim. Unchecked, monopolies are inevitable in a free market. I would go a step further and say that in a completely free market, after enough time passes, you end up with one giant monopoly that covers most, if not all, all sectors.

Re:And mathematicians, including

[nintendoeats]

I don't believe that this is a correct way to approach the issue. It is true that there are companies which had near monopolies which eventually lost market share. However, in most fo those cases case the company was bought by an even larger company. The real concern is that eventually there will only be a few VERY large companies which have so much economic power that they will be able to buy any company which usurps them in a particular area. See Nestle and Unilevere who already dominate their respective markets. A level of economic power this significant only needs to appear once in a given industry for that industry to be almost entirely controlled by a single entity, which will then do everything it can to maintain its position. Basically, the moment a company can buy anything that stands in its way you have a permanent monopoly.

Re:And mathematicians, including

[Archangel Michael]

I would even go so far as to suggest that monopolies are natural part of the system, that drives even more innovation. I doubt very much that Linux could exist in a world were there was no natural monopoly (Microsoft), as there would be no need for it if there was proper competition. This perspective is overshadowed by all the people crying "there ought to be a law" without thinking about why there ought not to be a law.

Or think about it this way, with Standard Oil having a monopoly, how many wars would have been fought over oil? And who would have fought for them? And maybe perhaps we would have solar / nuclear / "whatever we can't think of" instead of stupid dinojuice fueling our dreams.

Re:And mathematicians, including

[Waccoon]

All of these were market leaders who in many cases once owned 80% or more of their respective markets, til they were out-competed and were replaced as king of the hill.

Looking at that list, I recall most of them became so confident and arrogant about their market position that they felt they were invincible. I'd say laziness is the dominant reason, not misstepping. Every day was just internal politics, useless meetings, stupid ideas customers clearly hated but went ahead anyway, and endlessly pushing paper. My favorite modern example is Mozilla, which interestingly is following the same path as Netscape.

Monopolies fall eventually because they kill themselves through poor management, not because their large size is a liability and they are overwhelmed by more agile competitors. Some companies take a looooong time to enter that downward spiral, and can cause massive amounts of industry damage in the meantime. Then they get replaced by another market leader and the cycle starts again.

Re:Syringes

[hackwrench]

It seems to me that the war on drugs has made syringes harder to acquire and just keep around. I don't know what the hurdles are actually, though.

The real cost

[JustAnotherOldGuy]

"And Impax is also offering a coupon to reduce the cost to just $9.99 for qualifying patients."

Which means the actual cost of manufacturing an Epi-pen is probably abut 3 or 4 dollars.

From what I gather, the medicine itself is the cheapest component; the container and injector system accounts for ~75% of the cost.

Re:The real cost

[GerryHattrick]

If I were selling life-saving supplies in the USA's litigious climate, I would want to recover from each sale the probably-huge cost of insurance against confected claims.

Re:The real cost

[JustAnotherOldGuy]

If I were selling life-saving supplies in the USA's litigious climate, I would want to recover from each sale the probably-huge cost of insurance against confected claims.

Okay....and what's your point?

$8 vs $100 vs $600

[primebase]

For something that *costs* about $8, even $100 is not "super cheap"... http://www.mercurynews.com/201...

Re:$8 vs $100 vs $600

[Anonymous Coward]

There is a coupon that brings it down to $10. The $110 list price is just part of the insurance game.

As Adam Savage once said

[raymorris]

> Some folk take this site seriously

https://www.youtube.com/watch?...

gmo bees

[Anonymous Coward]

stinging people with lsd and meth and heroine would conclude all wars. Only the original dealers could withstand that cocktail: the senators and rep's.

It's amazing

[fred911]

When a 10,000% markup is celebrated as a discount from the status quo.

Sorry Free Market ? Tell that to the FDA

[Crashmarik]

http://www.npr.org/sections/he...

https://mises.org/blog/lack-ep...

They repeatedly stopped competitors

At least 20 years, sometimes more

[Shane_Optima]

the patent lasts like 5 or 10 or 20 years (I don't know)

Uh, it's 20 years, sometimes including an additional exclusivity period of up to 5 years (or apparently up to 10 years for certain antibiotics) offered by the FDA in some situations such that competitors' products will not be approved during that time. The exclusivity period isn't guaranteed to run consecutive to the patent period, although the drug companies obviously attempt to engineer it that way if possible.

I just thought that was worth clarifying. Like, "I'm don't recall if Joe was two or four or eight feet tall [and it turns out he might've been as much as twelve feet tall]"... that's not something you should hand-wave away. Yes, it's a complicated situation, but the government-created barriers to entry here (of which drug patents are just a tiny piece) are significant. We do need some barriers, obviously, along with some method of incentivization, but given the high or wildly fluctuating prices of some generics when there doesn't appear to be much of a marginal cost involved (I'm not necessarily saying that's the case with the epi-pens), the system as a whole does not appear to be functioning terribly well.

Re:At least 20 years, sometimes more

[drunken_boxer777]

While it might be 20 years, with the possibility of additional exclusivity, the clock starts when the patent is filed, not when the drug is approved and available for sale. It can take 10 years for a drug to make it to market after that clock starts ticking. Pharma companies have become more efficient at getting drugs to market and extending that exclusivity period, but it rarely lasts more than 12 years. That's part of the reason that there is a shift towards manufacturers developing biologics: the regulatory landscape in the US only just began allowing for biosimilars and the barrier to entry is very high. Barrier to entry for a generic small molecule is very low.

As for how well the system functions, we only need look at countries with single payer systems to understand what is wrong with pharmaceutical pricing in the US. The US govt is not allowed to negotiate prices with drug manufacturers. Medicare and Medicaid can choose not to cover a drug, but they can't be involved in setting the price. Contrast that with Germany, where there is a formula to determine the price of a new drug based on how much more efficacious and safe it is than the standard of care (not placebo). Not better than drug X? Then it can't cost more than drug X, possibly less, if it is even approved.

Re:At least 20 years, sometimes more

[HornWumpus]

IIRC if the drug is tied up by the FDA, they get 7 years from approval date. Special case.

CVS is still around?

[Anonymous Coward]

I thought everyone switched to git many years ago.

What corners did they cut?

[sethstorm]

I'd like to know what corners they cut for this one versus its equivalent.

Re:What corners did they cut?

[Anonymous Coward]

There's no reason to think any corners were cut, since $110 for a pair of injectors is still highway robbery considering the cost of the drug. If you see someone selling a pair of injectors for like $5 or $10, then you might suspect something is up, but $110 is still somebody profiting immensely off of the suffering of others.

Re:What corners did they cut?

[Orgasmatron]

Or maybe they are just trying to recover some of the millions of dollars they spent getting government approval to sell them.

Re:What corners did they cut?

[Keith_Beef]

Taken from https://en.wikipedia.org/wiki/...

As of September 2016, two EpiPens cost around $100 in France and around $200 in Germany.[40]

As of September 2016, two Jext autoinjectors cost about £8.5 in Britain, and the National Health Service pays around £48 (US$73.33) in order to make them available; that price was about 17 percent less than 2013.[40] US

In October 2016 the CEO of Mylan testified to Congress that Pfizer/King charged Mylan about $34.50 for one EpiPen.[29] The devices deliver about $1 worth of drug.[27] In September 2016, a Silicon Valley engineering consultancy performed a teardown analysis of the EpiPen and estimated the manufacturing and packaging costs at about $10 for a two-pack.[82]

The EpiPen, manufactured by King, a subsidiary of Pfizer, and marketed by Mylan, has dominated the market.[54] In 2007 when Mylan acquired the rights to market the product, annual sales of all epinephrine autoinjectors were about $200M and EpiPen had around 90% of the market; in 2015 the market size was around $1.5B and Mylan still had about 90% of the market.[28][54] Mylan raised the price from around $100 for a package of two EpiPens in 2007 to around $600 in 2016.[75] In the United Kingdom, an EpiPen costs £26.45 as of 2015.[83] In Canada they are about 120 CAD each.[84]

So, making them available at $50 each, CVS is not cutting any corners, just charging a similar price to what commercial suppliers in Europe are charging, and if those suppliers in Europe were not making an acceptable profit, they would abandon the business.

If Mylan is paying about $34.50 to its suppliers, it can charge $50 and be making $16 a piece on them. Let's say Mylan sold them at $60 a pop, that's $24, or almost a 70% mark-up, and still much less than the current price.

Re:Syringes

[Orgasmatron]

Strange. A few years ago, I bought hundreds of syringes, needles, etc for refilling electronic cigarette cartridges. They were cheap and plentiful, and usually came in boxes of 100.

Now sharpened needles appear to be difficult to find on Amazon. I did find a few, but their shitty search engine didn't make it easy. What I found was maybe double what I paid in 2010-2011 for a box. Check Tractor Supply Company, if you have one of their stores nearby. Or, there are other medical supply companies that still sell online.

As far as I can tell, there is no federal legal problem with buying or possessing needles. I don't know about other states, but mine has no problem with needles either. YMMV

Remember Heather Bresch

[Maxo-Texas]

CEO Heather Bresch basically destroyed one of Mylan's permanent cash cow for a few years higher profits (and higher bonuses for her).
As an investor, I'd be pissed.

Remember the name... Heather Bresch. Good for a short term profit but don't hold on to her companies long term.

What

[Dunbal]

$110 is still way too expensive. Syringe = $0.05. Epinephrine = $2.

Re:What

[Megol]

Comparing a syringe with a very easy to use auto-injector is dishonest and AFAIK the drug costs more. Still I have to agree that it is way too expensive, $20 should be enough for two injectors and even give a small profit.

Re:What

[Dr_Barnowl]

The epinephrine is actually much cheaper than $2 - maybe not in the states though. You can get double the amount of the same injectable solution there is in an EpiPen as an ampoule for £0.44 or 53 US cents. (UK NHS price).

Re:What

[MouseTheLuckyDog]

There is nothing hard about a syringe. Especially if you preload it.

Re:What

[moeinvt]

There are "fixed costs" and "marginal costs". You're considering only the latter and only the materials portion thereof. What about the wages and salaries, utilities, maintenance, packaging, shipping and other ongoing expenses?

Yes, after a company has done all the R&D, completed all the testing/trials, waded through the ocean of government red tape and built a manufacturing facility, the marginal cost of one additional unit might be small. However, the fixed cost of all the up-front investment has to be amortized over each unit produced.

And dare I suggest that a company needs to earn a profit in order to stay in business?

Re:What

[91degrees]

Wikipedia has prices;

"In October 2016 the CEO of Mylan testified to Congress that Pfizer/King charged Mylan about $34.50 for one EpiPen. The devices deliver about $1 worth of drug"

Honestly that seems quite a lot still, but I put that down to market inefficiencies.

Re:What

[Dunbal]

Yeah, $95 is the price of stupidity. And even then people will get it wrong with the auto-injector. Diabetics seem to manage and it's a lot easier to kill yourself with insulin.

Re:What

[Dunbal]

The epinephrine is actually much cheaper than $2

Yeah but you have to let the guy make SOME profit.

Re:What

[Dunbal]

Boo fucking hoo. Your argument does not apply to a situation where someone is charging 1000's of percent profit. The ONLY reason this happens is because it's a highly regulated, specialized industry with almost impossible barriers to entry AND a litigious mindset has convinced people that they're just too stupid to inject THEMSELVES the old fashioned way. Not to mention insurance companies who just pay whatever, because after all they just pass the cost onto YOU - they don't care.

This has nothing to do with some poor hard working soul barely earning a buck, and everything to do with greed and getting away with murder.

Re:What

[ventsyv]

What R&D? Auto injectors have been around for decades, adrenaline was isolated in 1901. The average flu shot cost $40 to the consumer, and those vaccines have to be reformulated every year to match the predominate flu strain. The epipen costs $10 to manufacture at the most. Even with variable cost and profit, it should not go over $40.

Re:What

[sconeu]

Diabetics are trained to use their syringes.

The idea of an epinephrine autinjector is that if you go into anaphylactic shock, someone else (who may be untrained) can use it on you.

Re:What

[Dunbal]

You do not instantly go into shock and training is available from any doctor or nurse. It takes all of 5 minutes.

Re:What

[sconeu]

"Hey guys! Let's go out to ${BAR}!!!!! Oh wait, first we have to have a five minute training session with a doctor!!"

Yeah. Right.

Who cares?

[Anonymous Coward]

I mean this literally... other than EpiPen salespeople, who cares? Every decade or two, when it's time to get a new EpiPen, I go to the EpiPen store, and I buy something that they have in stock, within my budget. I couldn't care if it was name brand, generic, or FairyDust powered. An EpiPen is an EpiPen is an EpiPen.

South African price

[Anonymous Coward]

South African Epipen price is about $64.

Re:Syringes

[MouseTheLuckyDog]

Nope. In many states a prescription is not even required.

Capitalism sort-of works, sometimes

[Overzeetop]

It's not that it's not workable, it's that the markets are not efficient (in the economic sense). Note that this took TEN YEARS to occur. Had the reaction been on the order of 3-6 months, I'd say it worked properly. The time from the beginning of price gouging to the current state where the cost is a single digit multiple of the production cost means that the marketplace is only reactive to massive imbalances.

Re:Capitalism sort-of works, sometimes

[XxtraLarGe]

It's not that it's not workable, it's that the markets are not efficient (in the economic sense). Note that this took TEN YEARS to occur. Had the reaction been on the order of 3-6 months, I'd say it worked properly. The time from the beginning of price gouging to the current state where the cost is a single digit multiple of the production cost means that the marketplace is only reactive to massive imbalances.

You don't think that the barriers to entry (patents & FDA) had anything to do with the "slow" reaction?

Re:Capitalism sort-of works, sometimes

[budgenator]

It's not that it's not workable, it's that the markets are not efficient (in the economic sense). Note that this took TEN YEARS to occur. Had the reaction been on the order of 3-6 months, I'd say it worked properly. The time from the beginning of price gouging to the current state where the cost is a single digit multiple of the production cost means that the marketplace is only reactive to massive imbalances.

You can't even fill out the FDA applications in 3 months.

There is always a monetary value on your child

[Overzeetop]

That's how companies in healthcare can get away with the prices they charge. They look at a $30 drug or $120 component (build cost) and ask "what would saving your [wife|child|eyesight] be MIN(worth to you, how much could you pay if you sold everything you owned and mortgaged your life's work potential). Then they look at the data a fit a curve which chooses a price which maximizes the return. Naturally, that cuts some people out of the game - but that's life (or death, or the use of a limb).

What you have to realize is (a) 1 in 10,000 is about 3 orders of magnitude greater than the average human can evaluate or imagine - we are VERY bad at outcome choices where probability estimates exceed about 1 in 5 to 1 in 8 and (b) the name brand has a finite failure rate which is often very similar to the generic. So, in your example, if the name brand had a 1 in 10,000 change of being "better", the likelihood is that there would be (and, yes, I'm making this up, but the efficacy rules support this general concept) a 1000 in 10,000 chance of a failure of the name brand, and a 1001 in 10,000 chance of failure of a generic. The difference is ridiculously small. (Note that a 90% efficacy of a single-shot medication is actually rather high, on average)

Speaking as a parent w/ a child alergic to peanuts

[Anonymous Coward]

Yes. Because there's no risk. Because I believe it when the FDA says that this product contains epinephrine. Whether it's Mylan's epinephrine or its CVS's epinephrine is irrelevant.

I think you're confusing generic products with generic chemicals. We're not arguing about the difference between Kleenex and Walmart-brand tissue (whose structural integrity will break no matter how gently you blow your nose). We're arguing about the difference between the caffeine in Coca-Cola and Walmart brand cola, which is no difference whatsoever. Caffeine is caffeine, and epinephrine is epinephrine.

If my child goes into anaphylaxis, we inject him with generic epinephrine, and it has no effect, then CVS will be facing one hell of a lawsuit from both me as well as a massive fine from the FDA. For the sake of profit, I cannot believe that CVS would ever put out a product as vital as an epinephrine injector that did not contain what its medical label claimed.

Less than inflation!

[sabbede]

$100 in 2007 is worth $116.40 today. The generic is cheaper than an Epipen at original price. As any generic should be and not like Mylan's "generic" that's still 3x the price the Epipen used to be.

I blame the trend of hiring CEOs from outside an industry. I say an MBA is not a sufficient qualification for one to run a pharmaceutical company. An MD or related PhD plus a career spent in the industry is a must. These nomadic CEOs (and fund managers who buy pharma companies) don't understand the mission, purpose, or responsibilities of the industry. They're trained to believe their only responsibility is to increase shareholder value and ignore any pre-existing and/or inherent responsibilities an industry might have.

Re:Less than inflation!

[Anonymous Coward]

"These nomadic CEOs don't understand...."

No, they understand quite well, they just don't care. They see an industry where the "customers" HAVE to buy their product or they risk severe injury and even death. To most CEO that is a dream come true. It doesn't help that our government is "fixing" our medical system by throwing crazy (R), regulations (D) & money at the problem and thinking it will go away on its own. The problem isn't going to be fixed by drowning doctors in paperwork or letting the industry (doctors, nurses, hospitals, manufactures) do whatever they want. It's going to be solved by streamlined regulations/requirements, open records (pricing, studies, etc) and competition.

"some method of incentivization"

[Anonymous Coward]

and that isn't always money. I noticed a lot of people mention money as if it was the only incentive... but some people do it just to help people. Money is not always required. A good example of this in Linux. I think it would be better for the whole life-saving medical side of thing be non-profit. Imagine... making medicine just to help people. It's crazy, I know!

Market economics

[sjbe]

Can you see ANYONE buying the Mylan epipen now even if they lower the price back to what it was?

Sure. I don't think most people are even remotely aware of what company makes the epipen. Furthermore the product works well in spite of the price gouging. So yes I think people would buy it if the price was right. That's the way markets are supposed to work. If someone charges too high a price the competition comes in and offers a better deal. The problem comes in when there isn't any competition. I wouldn't go so far as to say we should eliminate patents or anything drastic like that but clearly we do need government oversight of pricing when it comes to medicine. (every other country seems to have figured this out already) Medicine is not a field where wealth should be the sole determinant of whether you can get treatment or not. Allowing someone to die from anaphylactic shock because they are poor is hugely immoral and reprehensible. The government's job is in part to protect those who cannot protect themselves.

False dilemma

[sjbe]

Ok but admit that, given a choice, when your kid goes into anaphylaxis, you're not going to reach for the generic.

When that happens you're going to reach for whatever is available. Beggars can't be choosers as the saying goes. And personally I'd be quite comfortable reaching for a "generic" version of an epipen as long as it had all the right FDA stamps of approval and the like.

where's the evil mod?

[Anonymous Coward]

debating whether it would +1 cunningly evil or -1 psychotic

hyperbole

[Anonymous Coward]

That price isn't "super cheap". It's "significantly cheaper", or "much cheaper", but it's not "super cheap" (OK, the $9.99 price for people who qualify - that's super cheap - but that's not the price to which the headline is referring).

The word "super" is getting increasingly devalued by people like the person who wrote this headline. This person is probably one of those who no longer uses "who" for people, too. Pah!

(get off my lawn!!)

Insulin

[DarthVain]

I don't think it is quite as simple as even that. Take the drug Insulin for example. Discovered and essentially patented by a university for 1$ with the altruistic thinking that by allowing drug companies to produce it royalty free, more patients that desperately need the drug would be able to afford it. Didn't quite work out that way. Some interesting articles below.

http://other98.com/insulins-in...

http://insulinnation.com/treat...

$9.99 = true cost?

[Pascoea]

Interesting thought, if $9.99 is the lowest they are willing to sell this for, does that reflect the true market value if the product followed the markup of typical goods? Or are they selling it at a loss to be "good guys"?

Re:$9.99 = true cost?

[ventsyv]

The cost of the drug is $1 - $2, the cost of the injector $5 at the most. Depending on their overhead they might be making a profit even at $9.99

only for some definiions of super-cheap

[apcullen]

I used to buy epi-pens for $30 each. Then they went to $60 each... then... you know the story. $55 is way cheaper than $300, but it's still a far ways from "super cheap"

Expiration dates vs. acute emergency

[Anonymous Coward]

I think the consensus from the MD community is, if there's an actual life-threatening emergency allergic reaction, use any epipen that you've got. Even if it's expired, there could be enough epinephrine left to slow the allergy long enough for ambulance with good medicines to get there.

Still massive rip-off

[Anonymous Coward]

The cost of each dose is closer to $10 US. So the CVS version is still a rip-off.

Remember that CVS is charging $100 for something that cost about $30 at the most, and stop doing business with them!

Re:MUST be free not 100$

[budgenator]

We share a common name with a British Dentist and I've seen his website, while NHS dental care may be free, he's only seeing NHS patients once a week, it appears you can get free, you can get taken care without waiting 6 months for an appointment but not both. Hopefully this is a YMMV thing but I suspect it's not.

well, if you want to add-in

[Anonymous Coward]

some legal reforms to protect vendors from massive lawsuits (something Democrats, who are fueled by funds from the nation's trial lawyers, will never allow) then the price can probably be reduced a bunch more.

It's not just the price_of_the_components + price_of_manufacturing + price_of_packaging that goes into the price of a medical thing. There's the financial risk that you will sell a few thousand items and then get sued for hundreds of millions of dollars when somebody gets injured by one or just has a bad outcome while using the device. All that lawsuit risk adds to the price of things, which is why all medical stuff costs far more than the equivalent thing in a non-medical setting. Take a simple oscilloscope: a slow 4 channel unit can be had for a few hundred dollars. Put a new face plate on it with medical terminology and then sell it for use in a hospital and it magically becomes a $20k instrument. It's the regulatory approvals and the lawsuit risks that do this. Hearing aids are another example. Neither is a drug, but both are examples more in-line with Slashdotters and the epipen is a hybrid anyway being a disposable delivery mechanism with a pre-loaded drug.

CVS?

[definehypocrisy]

I thought everyone moved to Git or Subversion

ORL?

[Anonymous Coward]

What's the name of the "phancy" adrenaline that you manufacture?

You get forgetful when you get old

[Anonymous Coward]

And you are pretending that the horrid conditions of the Industrial Revolution didn't happen. The Hurst's, the Rockefeller's, and too many others ran this country just as the Koch's do a pretty good job of these days. Did you ever stop and think that those companies you listed acted right because they knew the government would smack them down? When we didn't, we had the 1880s-1920s. Microsoft got ballsy because they thought enough time had passed since the last big monopoly breakup. You'll think I am actually supporting your argument but remember that it was under a Democratic party that they were finally prosecuted. Bush 1 didn't care. So what I am saying is that if you can get a long enough stretch of whatever is the current-day Party of Business in charge, they will try to monopolize. They always have. Read a history book.

this is BS

[chstwnd]

this isn't "super cheap" this is inflated ABOVE the former regular prices as far as i can tell. Most of the sources I've found show that the previous (already inflated for profit) cost of epipens was $100 for two. So this represents a 10% increase in cost. Most of those same sources show that the actual cost to make them is a few dollars, so the cost of epipens in general is inflated hundreds of percent. you're contributing to the lies, OP