2. Heather Bresch
Daughter of Joe Manchin, a prominent politician
throughout her childhood.
Used her father's connections to help land a job at
Mylan, a generic drugs company (1992). Started off as
a sales clerk and worked her way to promotions.
Heather began to learn the business inside and out.
Was named President, COO, CIO of Mylan during her
time.
Was announced CEO of Mylan in 2011.
3. Heather Bresch
When she became CEO shortly
after the acquisition,
▫ Bresch focused on
marketing EpiPens, turning
a $200 million business into
a $1.1 billion business
▫ The EpiPen became Mylan’s
most important product,
accounting for $1 billion of
its $9.4 billion in sales in
2015.
7. Drug CEO Salaries
Epipen: Heather
Bresch - 18.9 million
REGN: Leonard
Schleifer - 47.5 million
VRTX: Jeffrey Leiden -
28 million
Johnson & Johnson:
Alex Gorsky - 23.8
million
http://www.cbsnews.com/news/whats-behind-the-sharp-rise-in-prescription-drug-prices/
8. EpiPen costs in other countries
Britain: $69
France: $100
Germany: $200
U.S: $600
9. Other Drug Companies
▫ Reuters analysis says that the
10 most popular drugs add
billions to U.S. health care
spending
▫ Conditions include arthritis,
asthma, abnormal cholesterol,
crohn's disease
10. EpiPen vs. Other
Drugs
Anti-Malaria drug, Daraprim,
5,000% increase
$13.50 to $750
Used to treat parasitic
infections and prevent a
nervous system infection in
those with HIV.
Will not allow a generic version
of the drug
Can do this because of
loophole ‘closed distribution
model’
http://www.cbsnews.com/news/whats-behind-the-sharp-rise-in-
prescription-drug-prices/
11. Blame on
intermediaries
including wholesalers,
retailers and
pharmacy benefit
managers
"That $608 is a list
price. What Mylan
takes from that, our
net sales is $274.”
The CEO’s Justifications for
Price Hikes
Mylan has costs that
include
"manufacturing the
product, distributing
the product,
enhancing the
product, investing."
12. “
No one's more frustrated
than me.
CEO Heather Bresch to CNBC
13. High-deductible health plans
High copayments
Out-of-pocket costs for
prescription medications
http://www.npr.org/sections/health-shots/2016/12/16/505851637/mylan-
to-sell-generic-epipen-at-half-the-price-of-original
http://www.cnbc.com/2016/08/25/mylan-expands-epipen-cost-cutting-
programs-after-charges-of-price-gouging.html
Blame on the Health-
Care System
14. Doubling eligibility for its patient assistance program
Pathway to order Epi-Pens directly from the company
Cut their generic to half the price of a regular epi-pen
Mylan’s Actions Towards Cost-Cutting
15. “
This isn’t a discount. It’s a
PR move.
Sen. Bernie Sanders
16. Allergy Statistics
In 2014, 4 million U.S
children had food allergies
▫ Almost 40% of these
children have severe,
life threatening
reactions
10% of people are allergic
to penicillin
5% have insect
allergies
40 U.S. deaths/year
Individuals, schools,
government offices
are all suppose to
carry multiple EpiPens.
http://www.aafa.org/page/allergy-facts.aspx
17. people are at risk from
anaphylaxis, or the
severe, life-
threatening allergic
reaction that EpiPen's
injection of
epinephrine is
designed to
counteract.
http://www.cnbc.com/2016/08/25/mylan-expands-epipen-cost-
cutting-programs-after-charges-of-price-gouging.html
Million
21. CEO Testifying
Refused to admit at any point
that her company raised the
price of the EpiPen to make
more money
Didn’t answer any questions of
revenue she was asked to
obtain ahead of time
22. Congress Didn’t Buy It.
Rep. Elijah Cummings acused
the company of using a "simple
but corrupt business model"
to enrich themselves in the
same manner as Martin Shkreli
of Turing Pharmaceuticals and
executives at Valeant
Pharmaceuticals.
http://www.businessinsider.com/mylan-ceo-heather-bresch-house-
oversight-committee-hearing-epipen-2016-9
23. Pending Trials
Several proposed class-
action cases against
drugmaker Mylan
involving EpiPens have
been brought in federal
courts.
http://www.usatoday.com/story/money/business/2016/12/30/la
wsuits-against-epipen-maker-mylan-moving-forward/95995348/
24. What about
Daraprim?
It seems that Daraprim has
acted alone in their price
increase.
There have not been any
proven evidence that they were
working with anyone in the
market when they spiked their
price.
25. Turing and the Closed Distribution Model
Open Distribution Model: “The allowance of the same types of
items to be carried and distributed in a certain area or region by
different sellers.”
26. Unclear Intentions
Stealing market share?
Kaleo Pharmaceuticals & the
Auvi-Q epinephrine auto-injector
Teva Pharmaceuticals & its own
generic EpiPen
http://www.npr.org/sections/health-shots/2016/12/16/505851637/mylan-
to-sell-generic-epipen-at-half-the-price-of-original
29. Possible Impact of the Trump
Administration
Donald Trump’s New Promise: I Will ‘Bring
Down Drug Prices’
Trump looking to do something about drug
companies (populist appeal)
http://www.forbes.com/sites/patrickcox/2016/12/14/trumps-fda-chief-may-implement-progressive-
approval-for-drugs/#431eb7c11c34
30. The Future of the FDA
Potential FDA chief appointee: Jim O’Neill
O’Neill has publicly supported a
“progressive approval” process for drugs
http://www.forbes.com/sites/patrickcox/2016/12/14/trumps-fda-chief-may-implement-
progressive-approval-for-drugs/#431eb7c11c34
34. “
“It's a kind of pay-or-die pricing system for the EpiPen. Parents
are really frantic about how they're going to pay for this.”
Ralph Nader
“The cost of epinephrine is literally less than a Big Mac.”
Mark Baum, Pharmaceutical CEO developing an alternative
Editor's Notes
Introduce ourselves: Cassandra & teghan
Bring in other drugs as well
What other drugs could be hiked up as well...next one?
Different countries handling it differently ?
Insulin as well
Finances of companies...why they doing this is it finance related? (Nicole)
How can they get what they want without over charging consumer
Corporate compensation
It's not a crazy drug, just basic stuff why can they charge so much for this
Alex
alex
As of Dec it was closing at just under 40. In 2012 it was around 20. Doubled in 5 years
nicole
Comparing it to Pfizer and Aztrezenca, they also had all positive, Gross profit, Operating income, and Net Income. A much larger scale but they seem to produce a broader amount of drugs.
nicole
Teghan - more than 500% increase
Alex
According to NBC News, Bresch earned $2,453,456 in 2007, the year of the EpiPen acquisition. In 2015, Bresch’s total compensation was $18,931,068.
Jeffrey Leiden, CEO of Vertex Pharmaceuticals. Has been CEO of the company since 2012. He earned $28 million last year. The company is known for producing the drug Kalydeco. In 2015, the cost of Kalydeco increased.
Leonard Schleifer, CEO of biotech Regeneron Pharmaceuticals. He was awarded a compensation packaged valued at $47.5 million last year. The 63-year-old executive has been CEO of the company since 1988 and got a 13% raise in his total pay last year.
Some countries have health care to even cover all costs
Teghan
Source: https://www.bloomberg.com/news/articles/2016-09-29/epipen-s-69-cost-in-britain-shows-other-extreme-of-drug-pricing-itnvgvam
Jason
Jason
doxycycline : Common antibiotic, helps with acne and lyme disease
Isuprel: treats asthma and heart block
Nitropress: high blood pressure, congestive heart failure
http://www.cbsnews.com/news/whats-behind-the-sharp-rise-in-prescription-drug-prices/
teghan
Teghan
Nicole
In 2007 when it was introduced the genric epipen sold 3 times the amount of a regular one
Opening a pathway so that patients can order EpiPen Auto-Injector directly from the company, thereby reducing the cost.
http://newsroom.mylan.com/2016-08-25-Mylan-Taking-Immediate-Action-to-Further-Enhance-Access-to-EpiPen-Epinephrine-Injection-USP-Auto-Injector
- “United States antitrust law is a collection of federal and state government laws that regulates the conduct and organization of business corporations, genreally to promote fair competition for the benefit of consumers.”
-Did they did break any of the antitrust laws by speaking with insurers, pharmacies, or distributors about incentives or exclusionary contracts.
-http://www.cbsnews.com/news/whats-behind-the-sharp-rise-in-prescription-drug-prices/ -
https://www.wsgr.com/publications/PDFSearch/law360-0915.pdf
http://www.cnbc.com/2016/08/23/us-lawmakers-press-mylan-on-epipen-price-increases.html
http://gizmodo.com/do-mylans-epipen-contracts-with-schools-break-antitrust-1786263484
-New York Attorney General is investigating Mylan and plans to hold them responsible if they did in fact get involved in anti-competitive practices.
MONOPOLY:
-It is difficult to fight against these pharmaceutical brands
-Not a lot of government involvement, but politicians can state their opinions and try to influence decisions.
-CEO’s have the control over what they do with their prices.
-Store brands usually even these prices out, but some medications are not used enough for a store brand to come out.