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Sticker Shock: What's behind high prices at the pharmacy?

Posted at 2:13 AM, Jul 05, 2016
and last updated 2016-07-05 03:17:31-04

Prescription drug costs are skyrocketing and it’s causing sticker shock at the pharmacy.

These are drugs that have been around for years. The medications haven't changed, but the price tags have, and manufacturers don’t have to explain the markup.

This is happening to lifesaving drugs, like the EpiPen. It delivers a quick dose of epinephrine to counter a severe allergic reaction. 

“It was 21 months ago that our 18 -year-old son Dillon got stung by a bee and went into anapheleptic shock. We did not know that he was allergic,” explained Angel Mueller.

George and Angel Mueller’s son Dillon spent a week in a coma before he passed away. “It was then that I made a promise to myself that I would do whatever it takes to help other families not to have to go through such a tragedy,” explained Mueller.

Dillon’s parents are now epinephrine advocates and are working to make the drug available to the public without a prescription. The Mueller’s were shocked though, to find out how much an EpiPen can cost.

It’s a familiar feeling, for Dave Pozorski’s family. His son Zach was diagnosed with a severe peanut allergy at four.  The EpiPen has been a constant companion until this year when Dave went to refill Zach's prescription and experienced sticker shock when the pharmacist told him it would be $528.  “We were like uh, no.  I don't think so."

From 2007 to 2014 the wholesale price for the EpiPen skyrocketed.  It's up more than 200%.  It’s something that's happening to many prescription drugs that have been around for years, like a common antibiotic used to treat bacterial infections.  Doxycycline went from $20 a bottle to more than $1800 in just one year. That's more than a 9,000% increase

Bill Quandt owns a Pharmacy near Milwaukee.  He says he's never seen anything like this.  "There's no explanation, no logical explanation for that," Quandt said.

Some of the medications have become so expensive that he's stopped pre-ordering them. “We're not at fault but we have to say that's what you got to pay."

There are no tools in place to control what drug makers charge for their products. In most cases companies also don't have to share what it costs to make a drug or why it’s been marked up.

According to one national trade association health plans and consumers are on the same side in this, because both end up absorbing the increase.  Spokesperson for America's Health Insurance Plans, Clare Krusing, says "ultimately we are all paying for prescription medications. We're paying for it in our premiums, and we're paying for it in higher out-of-pocket costs."

The Muellers understand how a high price tag can worry families. “I do not think there is one single reason that it needed to skyrocket that high," said Angel. 

After Zach's allergic reaction a month ago the Pozorski's pooled money from friends and family and bought a new EpiPen kit, but they're already worried about next year. "What are we gonna do? Have to fork out more than $400? Is the sky the limit in this?"

Mylan, the manufacturer of the EpiPen, about the drastic price increase.  Here's the companies full statement:

"Mylan has worked tirelessly over the past years advocating for increased anaphylaxis awareness, preparedness and access to treatment. As the leaders in this space, our efforts are aimed at benefiting those living with potentially life-threatening (severe) allergies, and we take this leadership position seriously.

Mylan does not set the final retail cost of its products charged to patients. One would have to look across the many parties that constitute the distribution channel as they all play a role in the ultimate access and retail price of prescription drugs in the marketplace.

We are proud of our patient programs which help support access to treatment:

·         Today nearly 250 million insured Americans have access to EpiPen® (epinephrine injection) Auto-Injector. For a vast majority of patients, insurance coverage coupled with Mylan's My EpiPen Savings Card™ means that they could be eligible to receive up to three EpiPen 2-Pak® or EpiPen Jr 2-Pak® cartons per prescription at no cost. Additionally, Mylan offers a patient assistance program for qualifying patients.
·         With the rate of food allergies among U.S. children on the rise, now affecting one in 13, preparedness for anaphylaxis in the school setting is critical. Mylan implemented the EpiPen4Schools® initiative in 2012, which provides four free EpiPen® or EpiPen Jr® (epinephrine injection) Auto-Injectors to qualifying schools in the U.S. Today, more than 64,000 schools have participated in the program, including more than 1,500 schools in Wisconsin, and 47 states now have laws related to stocking epinephrine auto-injectors so they may be available to someone experiencing anaphylaxis in the school setting. Several cases in schools across the country in which the free EpiPen® Auto-Injectors were used to treat an anaphylactic reaction underscore the positive impact of the program.
·         To further our mission and commitment to ensuring access to treatment, we continue work to expand access to epinephrine beyond schools. Twenty-six states now have entity epinephrine stocking legislation so that public places such as restaurants, colleges and universities, and child care facilities may stock undesignated epinephrine auto-injectors.

We look forward to continuing our unparalleled efforts to drive anaphylaxis awareness, preparedness and access to treatment in support of the millions of families in the U.S. that are managing severe allergies.

 

Helpful Links

Epi pen saving card- https://www.epipen.com/copay-offer/

Then and Now Cost of Prescription Drugs-  https://www.ahip.org/then-and-now-the-cost-of-prescription-drugs/

Dillon's parents started an online petition, and they have thousands of signatures in support of changing how the FDA classifies the drug to make it easier for anyone to get it.