There is something wrong when companies can purchase another company’s product, limit competition, and jack up the price. Normally, one would say that is good business. But healthcare is not your usual business. Adding fuel to the fire, it appears the FDA did not approve two EPi-PEN competitors earlier in 2016 over non-safety issues. This has led to questions of anti-trust and even conspiracies that the Mylan is able to influence the FDA. ACEP has looked at legislation on use and will follow legislation on how to deal with shortages and alternatives.
EpiPen prices aren’t the only thing to jump at Mylan. Executive salaries have also seen a stratospheric uptick.Proxy filings show that from 2007 to 2015, Mylan CEO Heather Bresch’s total compensation went from $2,453,456 to $18,931,068, a 671 percent increase. During the same period, the company raised EpiPen prices, with the average wholesale price going from $56.64 to $317.82, a 461 percent increase, according to data provided by Connecture.In 2007 the company bought the rights to EpiPen, a device used to provide emergency epinephrine to stop a potentially fatal allergic reaction and began raising its price. In 2008 and 2009, Mylan raised the price by 5 percent. At the end of 2009 it tried out a 19 percent hike. The years 2010-2013 saw a succession of 10 percent price hikes.Mylan Inc. Chief Executive Officer Heather Bresch InterviewHeather Bresch, chief executive officer of drugmaker Mylan Inc., speaks during an interview in New York, U.S., on Thursday, Jan. 8, 2015. Victor J. Blue / Bloomberg via Getty Images fileAnd from the fourth quarter of 2013 to the second quarter of 2016, Mylan steadily raised EpiPen prices 15 percent every other quarter.The stock price more than tripled, going from $13.29 in 2007 to a high of $47.59 in 2016.And while sales of the life-saving drug rose to provide 40 percent of the company’s operating profits in 2014, as Bloomberg reported, salaries for other Mylan executives also went up. In 2015, President Rajiv Malik’s base pay increased 11.1 percent to $1 million, and Chief Commercial Officer Anthony Mauro saw his jump 13.6 percent to $625,000.
Mylan also amped up its lobbying efforts. In 2008, its reported spending on lobbying went from $270,000 to $1.2 million, according to opensecrets.org. Legislation that enhanced its bottom line followed, with the FDA changing its recommendations in 2010 that two EpiPens be sold in a package instead of one and that they be prescribed for at-risk patients, not just those with confirmed allergies. And in 2013 the government passed a law to give block grants to states that required they be stocked in public schools.
This isn’t the first time the company’s executives have been touched by a scandal.A 2008 inquiry found Bresch didn’t complete the coursework for her MBA granted by West Virginia University. The school had received a $20 million donation from Mylan chairman Milan Puskar in 2003.Several of the university administrators resigned in the aftermath, including president Mike Garrison. The former Mylan consultant and lobbyist had gone to high school with Bresch, the daughter of West Virginia Senator Joe Manchin, and was a longtime family friend.As NBC News previously reported, the sharp increases in price haven’t escaped the attention of parents worried about paying for the drug in the back-to-school scramble, and Congress is starting to scrutinize Mylan’s pricing.