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Loose rivets
29th Aug 2016, 21:25
Mylan chief executive Heather Bresch said the company had spent hundreds of millions of dollars improving the product since buying the product from Merck in 2007.


What is it? That's a lot considering it's been invented, developed and produced already. A space shuttle? Perhaps just a driverless car . . . no, it's a :mad:in' EpiPen.

So effin' expensive in fact, my GP won't reissue me with one. "It will only buy you ten minutes." Oh, about the time it takes an ambulance to get to me. Okay, I'll accept I'm old and perhaps should die anyway, I'll also accept when I had the big one, no ambulance came anyway. Then, it was because I could not provide an address as the scene of my crisis.

Oh, again . . . sat with someone the other night for three hours - it has to be said, with a lovely paramedic - and even she couldn't get an ambulance. She even offered to drive the patient the 20 miles herself some 20 hours after rising that morning.

Anaphylaxis not too dangerous? The young consultant at Addenbrooks said I can't possibly have survived such an attack, therefore I can't have had one. Oh, my :ugh:

Sue VÍtements
29th Aug 2016, 21:56
It would be cheaper to use the EpiPencil

meadowrun
29th Aug 2016, 22:15
Apparently someone is to produce a "generic" epipen to reduce costs.


Meanwhile, they can get back to spending millions to improve the smell of your laundry fresheners.

G-CPTN
29th Aug 2016, 22:51
The cost of EpiPens in the US has risen by 500% in less than a decade (http://www.bbc.co.uk/news/business-37215189).

vapilot2004
29th Aug 2016, 23:47
...and to think there are those that are against government regulation...

VP959
30th Aug 2016, 08:07
This sounds just crazy. The things have been around for a very long time; I recall having to use the one my sister carries when she went into anaphylaxis at Christmas dinner, because (unknown to all of us) there was a trace of nut product in something. Watching someone stop breathing because their airway has blocked within seconds is not funny. Seeing the miraculous effect of an Epipen shot save her life was just astounding.

Having looked at the thing closely, and used it for real, I cannot possibly believe that it could cost that much money. Thankfully, my sister still has hers issued by the NHS, and has had for years. Before that she had to carry around a vial of epinephrine and a syringe, but I know for a fact that she's had an Epipen for at least 20 years now, as it was in the late 1990's when she had that attack at Christmas.

The design looked to me to be near-identical to the emergency morphine injectors that we had in our survival kits back in the 1980's, so there can't be anything really new about the basics of the thing. It's not as if epinephrine is an expensive drug either, so there seems very little to justify the very high price.

Martin the Martian
30th Aug 2016, 13:03
No, it doesn't cost that much to make, but what the manufacturers charge the NHS or other health provider bears no relation to the production costs. That's where the difference is.

tdracer
30th Aug 2016, 16:08
...and to think there are those that are against government regulation...
Well, since you brought it up, at least two companies have come out with generic versions of the "EpiPens" but have been unable to get FDA approval. Some think the reasons for the FDA rejections of the generic versions are rather dodgy.
So yes, perhaps there is too much government regulation.

tdracer
30th Aug 2016, 16:10
No, it doesn't cost that much to make, but what the manufacturers charge the NHS or other health provider bears no relation to the production costs.
And that's different from any other product how?

VP959
30th Aug 2016, 16:32
I detect a lot of BS around this, with "new" patents being filed to keep a generic and very well proven 40+ year old design still under patent protection.

99% of these things get thrown out unused every year, as they have a one year shelf life IIRC. The new design looks more shapely than the ones I remember from years ago, but does that matter at all? The bottom line is that these things are just a really simple, almost foolproof, way of delivering a very cheap life-saving drug very quickly, by an untrained person.

When I injected my sister I didn't even stop to read the instructions on the thing, as she was turning blue in front of me. It looked very similar to the morphine auto-injectors, so I just ripped it out of the packaging and jabbed it in her upper arm.

AFAIK, auto-injectors haven't changed much in the basic principle of operation. The things were designed to be used by anyone, anywhere, with only minimal training (as in open the packet, put the injection end against a big muscle and press the button). I bet the Chinese could knock them up for a few pence (they probably do).

Given that the original patents on the first auto-injectors must have expired a long time ago, and as they were well-proven and manufactured for decades, what's to stop a company just making those today? I'm guessing that it's politics, and that the major manufacturer has leant on the government to keep their monopoly by manipulating approval...................

MG23
30th Aug 2016, 16:59
...and to think there are those that are against government regulation...

This is precisely why we're against government regulation.

The US government won't let competitors into the market without spending years jumping through hoops to sell essentially the same product, and has made importing drugs from abroad a criminal offense.

If anyone could make them and sell them from amazon.com, prices would collapse. But, no, that's illegal.

Medical regulation has been one of the biggest disasters in the history of the world.

spInY nORmAn
30th Aug 2016, 21:01
Adrenaclick is touted as a cheap, FDA approved alternative to the EpiPen. Available for as low as US$145 for a 2-pack at WalMart: Adrenaclick Prices and Adrenaclick Coupons - GoodRx (http://www.goodrx.com/adrenaclick) It's often not prescribed as many doctors don't know about it because EpiPen has become synonymous with epinephrine auto-injectors and pharmacies can't substitute this cheaper alternative if the Rx states "EpiPen".

sitigeltfel
30th Aug 2016, 22:12
Medical companies have to spend millions/billions researching and testing products and in some cases wait for years to gain certification before they can earn one penny from them. The money they make not only goes to reimbursing them, but also to provide the funding for new medicines. The same conditions apply to all manufacturing processes. If you can't accept that, and are from the something for nothing tribe, then you should buy a chemistry set and put aside a bit of your garden to grow some exotic herbs. See if you can do any better.

meadowrun
31st Aug 2016, 02:23
Yes, medical companies do invest millions and do deserve to make a profit.
Still doesn't explain why an EpiPen costs five times as much in the USofA than it does in Canada. It is just a fancy, ease of use, re-packaging of an existing, known for ages, medicine.

fitliker
31st Aug 2016, 02:37
I knew they must be valuable as my friend gave me one. It was the last thing he did before he died . I was deeply moved by his kindness.

Hempy
31st Aug 2016, 06:18
$37 in Australia ($27.80 USD). $0 if you have a health care card.

VP959
31st Aug 2016, 07:21
Medical companies have to spend millions/billions researching and testing products and in some cases wait for years to gain certification before they can earn one penny from them. The money they make not only goes to reimbursing them, but also to provide the funding for new medicines. The same conditions apply to all manufacturing processes. If you can't accept that, and are from the something for nothing tribe, then you should buy a chemistry set and put aside a bit of your garden to grow some exotic herbs. See if you can do any better.

Agreed, but that's way, way off the point here. This is technology that was developed by the government over 40 years ago. It's been in common use by the general public for at least 20 years.

There's nothing particularly challenging about the design of these things; they are simply an injection unit that injects a known dose of a very cheap generic drug using a short needle, so that there is minimal risk of harm if misused (in fact, the things are hard to misuse, they are that simple).

AFAICS, the manufacturer of the Epipen has been polishing a turd for the past few decades, and ensuring only these very expensive polished turds get approved. They are trading on the fact that their trademark, Epipen, has become a generic term for epinephrine auto-injectors.

Perhaps the best tactic would to boycott the use of the term "Epipen" and use the generic term auto-injector instead.

ORAC
31st Aug 2016, 13:55
The FDA and the EpiPen Shock - Marginal REVOLUTION (http://marginalrevolution.com/marginalrevolution/2016/08/the-fda-and-the-epipen-shock.html)

Flash2001
31st Aug 2016, 16:01
Must be a bit more than 40 years. We had similar technology to inject atropine for nerve gas exposure in 1956.

After an excellent Landing etc...

Loose rivets
31st Aug 2016, 22:15
When I've discharged the two I had, they go with one heck of a bang - into a wooden breadboard in my case. Certainly well made but so are a lot of things that haven't gone up hundreds of %.

vapilot2004
1st Sep 2016, 09:16
This is precisely why we're against government regulation.


I agree, some areas should have less regulation, like Medicare, one of the largest buyers in the world of prescription drugs, yet is by-statute prohibited from negotiating price breaks from drug companies despite those same companies negotiating better prices with foreign governments routinely and legally.

We do not regulate pricing on drugs in the US however we do regulate effectivity and safety because we would like to avoid another Thalidomide/DES/Phen Fen disaster. Outside of the Medicare issue but still on the issue of price controls, a RAND study concluded there is a correlation between drug company profits and the pace of innovation. Yet, instead of, say a new drug to help fight malaria, we get dick drugs for the western world - Altruism - 0, Shareholders 1.