Mylan and the Monopoly of EpiPen

In the game of Mylan Monopoly, there is no bonus money or trips to jail, but you will pay the banker for the real estate. The lifesaving EpiPen is a necessity for many Americans, and the drug’s list price has blown through the roof. A two-pack of epinephrine injectors has gone from less than $100 in 2007 to $608 today.

Mylan, the maker of EpiPen, is offering coupons and financial assistance to help with the recent price hike, but some patients and their health insurance plans will still be left with the full cost. Mylan thought that insurers would carry most if not all of the total. The price of the EpiPen has increased with rising demand, with the number of prescriptions doubling in the last decade to 3.6 million.

The Mylan monopoly has been formed as a result of failed competitors, patent protections, and laws requiring allergy medications in schools. They lobbied lawmakers to increase availability of EpiPens in schools across the country. The “EpiPen Law” was signed in 2013, giving incentives to states who mandate schools to stock the injectors. Eleven states have required states to stock epinephrine. Putting their products in schools is free marketing for the company. Mylan has given away more than 700,000 free EpiPens to schools.

The Federal Aviation Administration reauthorization bill passed last April requires that all airlines carry EpiPens on board aircraft. The company also made a deal with the Walt Disney Parks and Resorts to create a website and storybooks for families with severe allergies.

When EpiPen came on the market in 2007, Mylan products were 90% of the epinephrine market, while Twinject had the other sliver. Twinject was clumsier and not as appealing to patients; it was discontinued in 2012. The Auvi-Q was recalled in 2015 for dangerous design flaws. The Adrenaclick maintains a small part of the market. Teva Pharmaceutical is working on a generic autoinjector, but will not launch until at least 2017.

Many parents have never tried another type of injector besides the EpiPen, but are willing to try alternatives. The large, biannual price increases since 2009 are leading patients to look to other options.

Mylan has not adequately explained the recent cost increase for a product that has been on the market for more than thirty years.
Johnson, Carolyn and Ho, Catherine. “How Mylan, the maker of EpiPen, became a virtual monopoly.” Business. The Washington Post, 25 Aug 2016. Web. 27 Aug 2016.

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