EpiPen Scandal: NJ Lawmakers Say Drug Prices Gouge and ‘Rape’ Consumers
TRENTON — Though their options for action are limited, state lawmakers held two hearings Thursday aimed at addressing the sharp hike in the cost for EpiPens, the market-dominant epinephrine devices that can quell a life-threatening allergic reaction.
Over the last decade, the price has risen from around $50 for an injector to more than $600 for a two-pack. That’s a steep rise, particularly if you consider the pens need to be replaced every year and, if needed, can only be used once.
The Senate health committee heard testimony on the topic for 75 minutes. The Assembly health committee advanced a bill that seeks to give pharmacists procedures to seek approval for alternatives to EpiPens, as well as a resolution urging the Food & Drug Administration to move more quickly to approve competitors to Mylan. The pharmaceutical company declined to attend the hearing, or submit a response, and came under frequent and not unexpected withering criticism by lawmakers.
“The cost is just outrageous and predatory. And it shouldn’t be $600,” said state Sen. Joseph Vitale, D-Middlesex.
“I hate to throw around the word ‘crisis,’ but this is something that is of public concern, of concern to the public health and ... I think for most people shocks the conscience that we have, that we’re witnessing this kind of — I’ll use the term price gouging — by a company that really has the backs of people up against the wall,” said Assemblyman Herb Conaway, D-Burlington.
Lawmakers said the cost to produce an EpiPen is probably less than $30. State Sen. Robert Singer, R-Ocean, called the markup for that and other drugs “frightening.” State Sen. Richard Codey, D-Essex, called it price gouging that should be fought by New Jersey and other states’ attorneys general.
“The driver of health care (costs) nowadays is not hospitals and doctors, whatever. It’s drug companies. Drug companies like this company, who have no respect for our taxpayers, have no respect for the health care system, and would rape people with these outrageous prices,” Codey said.
“It’s price gouging at its worst. And it’s why the United States government should take action,” Codey said. “I can remember the Clinton days, where they threatened to have drug pricing controls. And all of a sudden, the prices of our drugs came down. You’ve got to do that again. You’ve got to threaten them. You’ve got to do whatever you can to hold down these costs.”
Pharmacists and representatives from health-care associations told lawmakers they support and understand the focus on EpiPens but that the issue is larger than that. Pharmacist Dominick Vizzoni, who owns pharmacies in Trenton and Allentown, said erythromycin, an antibiotic, used to cost $5 for a bottle of 100 but is now $953. Tetracycline costs $658 for 100 pills, while Vizzoni used to buy 1,000 for $10.
“The villain here in this case is Mylan. But that’s only one aspect of drug costs,” said Anthony Reznik, director of government affairs for the Independent Pharmacy Alliance.
“This is not related just to Mylan. There’s lots and lots and lots of examples,” said Ward Sanders, president of the New Jersey Association of Health Plans. He added later: “Yes, this is America, and we believe in free markets generally. But free markets don’t work in certain contexts. And when there’s no competition, then there has to be regulatory bumper guards around that.”
Vitale said the Senate health committee would look to hold a second hearing on pharmaceutical prices more broadly.
A syringe that delivers epinephrine can be built for $10 and some emergency squads that can’t afford EpiPens are doing that, said Laurie Clark, legislative counsel for the New Jersey Pharmacists Association.
“Now it’s to the point where we’re rationing care. If you have money, you can afford to buy it. But guess what? Most people don’t have that kind of money,” Clark said.
Dr. Lauren Carruth, a family practitioner, said the value of injectors like EpiPens, rather than syringes, is that it’s possible for a person suffering from anaphylaxis to inject themselves and easier for adults to administer it to a child during an emergency.
“Your blood pressure drops. You get lightheaded, you get dizzy. Your tongue starts to swell. Your windpipe starts to swell. You can’t administer a syringe to yourself,” Carruth said. “And I’m a physician and if my child was on the floor writhing, I don’t know that I could draw it up and give it.”
Lawmakers indicated they’d consider other potential legislation, such as requiring EpiPens to be sold in single packs, rather than double, and absolving parents of children with life-threatening allergies from having to send an injector to school, instead relying on the school to pay for emergency supplies.