What others say: EpiPen a case study in government, business pushing drug prices up

A couple of years ago Washington fell into anaphylactic shock over the high cost of EpiPens, devices that shoot adrenaline into someone having an allergic reaction. But the Trump Administration this week injected some overdue competition into the market that could lower prices for millions of Americans.

On Thursday the Food and Drug Administration approved the first generic competitor to Mylan’s EpiPen. The competing drug is manufactured by the Israeli pharmaceutical company Teva. One might wonder why a simple spring device filled with a cheap medicine didn’t have competitors, even decades after invention.

That was one question in 2016, when Congress hauled in Mylan CEO Heather Bresch to register outrage about the more than $600 list price of a two-pack of pens, which millions of kids and adults have to keep on hand. Not everyone pays full price after rebates and discounts, and some of the shock came from insurance designs that increased out-of-pocket costs. But the sticker price had increased more than 500% over 10 years.

ADVERTISEMENT
0 seconds of 0 secondsVolume 0%
Press shift question mark to access a list of keyboard shortcuts
00:00
00:00
00:00
 

Yet if Mylan kept prices high, the company had help from the FDA. The agency had not articulated standards for a class of drugs known as “complex generics” such as inhalers, which are more fraught than proving similarity to, say, a molecule pill. Mylan thus had no direct competition, though it now sells its own generic copy.

Other injectors are on the market but a pharmacist can’t substitute these versions thanks to issues as minor as the instructions for the device, though there is no clinical distinction. Companies like Teva have spent years ensnared in FDA processes, and in the meantime Mylan could increase prices without market consequences.

Before he became the current FDA Commissioner, Scott Gottlieb told Congress in 2016 about the “Catch-22” for drugmakers: They couldn’t win approval as a generic because another injection device wasn’t exactly the same as EpiPen, but other regulations also make it hard for competitors to get branded alternatives through the FDA’s new drug approval pathway.

Dr. Gottlieb has made clarity for such complex generics a priority at the FDA, and on Thursday he called the Teva device approval part of the agency’s efforts to remove barriers to competition. The approval is particularly timely amid supply shortages of EpiPens.

On all the evidence, products face the sharpest price decline when two generics are competing with the branded version. More drugmakers will jump into a market if they see an opportunity to make money and a regulatory agency that doesn’t construct needless barriers to entry.

At the time of the EpiPen brouhaha, Hillary Clinton called for a federal “consumer response team” that would rove around and penalize companies for price spikes. The laugh-cry moment is that the Trump Administration has flirted with a response from the Clinton playbook: Importing price controls from Europe for drugs with expired patents that lack competition.

President Trump seems to think that drugs are too expensive because of unfettered markets, but the EpiPen episode is a reminder: The real culprit is often not too much freedom but big business exploiting big government to keep prices high.

—The Wall Street Journal, Aug. 19, 2018

More in Opinion

Deena Bishop, commissioner of the Department of Education and Early Development, discusses the status of school districts’ finances during a press conference with Gov. Mike Dunleavy at the Alaska State Capitol on Thursday, April 17, 2025. (Jasz Garrett / Juneau Empire)
Opinion: The fight to improve public education has just begun

We owe our children more than what the system is currently offering

President Donald Trump and President Vladimir Putin of Russia at a joint news conference in Helsinki, Finland, July 16, 2018. (Doug Mills/The New York Times file photo)
Opinion: Mistaking flattery for respect

Flattery played a role in Trump’s One Big Beautiful Bill.

(Juneau Empire file photo)
Opinion: Life is harder when you outlive your support group

Long-time friends are more important than ever to help us cope, to remind us we are not alone and that others feel the same way.

Deven Mitchell is the executive director and chief executive officer of the Alaska Permanent Fund Corp. (Photo courtesy of the Alaska Permanent Fund Corp.)
Opinion: The key to a stronger fund: Diversification

Diversification is a means of stabilizing returns and mitigating risk.

A silver salmon is weighed at Three Bears in Kenai, Alaska. Evelyn McCoy, customer service PIC at Three Bears, looks on. (Photo by Jeff Helminiak/Peninsula Clarion)
Opinion: Will coho salmon be the next to disappear in the Kenai River?

Did we not learn anything from the disappearance of the kings from the Kenai River?

Jonathan Flora is a lifelong commercial fisherman and dockworker from Homer, Alaska.
Point of View: Not fishing for favors — Alaskans need basic health care access

We ask our elected officials to oppose this bill that puts our health and livelihoods in danger.

Alex Koplin. (courtesy photo)
Opinion: Public schools do much more than just teach the three Rs

Isn’t it worth spending the money to provide a quality education for each student that enters our schools?

Gov. Mike Dunleavy speaks to reporters at the Alaska State Capitol on Thursday, April 17, 2025. (Jasz Garrett / Juneau Empire file photo)
Letter to the Editor: Law enforcement officers helped ensure smooth, secure energy conference

Their visible commitment to public safety allowed attendees to focus fully on collaboration, learning, and the important conversations shaping our path forward.

Laurie Craig / Juneau Empire file photo
The present-day KTOO public broadcasting building, built in 1959 for the U.S. Army’s Alaska Communications System Signal Corps, is located on filled tidelands near Juneau’s subport. Today vehicles on Egan Drive pass by the concrete structure with satellite dishes on the roof that receive signals from NPR, PBS and other sources.
My Turn: Stand for the community radio, not culture war optics

Alaskans are different and we pride ourselves on that. If my vehicle… Continue reading

U.S. Sen. Dan Sullivan (R-Alaska) delivers his annual speech to the Alaska Legislature on Thursday, March 20, 2025. (Jasz Garrett / Juneau Empire file photo)
Opinion: Sullivan, Trump and the rule of lawlessness

In September 2023, U.S. Sen. Dan Sullivan established his own Alaska Federal… Continue reading

UAA Provost Denise Runge photographed outside the Administration and Humanities Building at the University of Alaskas Anchorage. (courtesy photo)
Opinion: UAA’s College of Health — Empowering Alaska’s future, one nurse at a time

At the University of Alaska Anchorage, we understand the health of our… Continue reading

U.S. Rep. Nick Begich III, R-Alaska, address a joint session of the Alaska Legislature on Thursday, Feb. 20, 2025. (Mark Sabbatini / Juneau Empire file photo)
Opinion: A noncongressman for Alaska?

It’s right to ask whether Nick Begich is a noncongressman for Alaska.… Continue reading

You're browsing in private mode.
Please sign in or subscribe to continue reading articles in this mode.

Peninsula Clarion relies on subscription revenue to provide local content for our readers.

Subscribe

Already a subscriber? Please sign in