A number of reported upgrades were made to the device over the years, like a retractable needle and better grip for the pen. Many factors go into the cost of drugs, Hoadley explained, like the cost of ingredients, and producing and manufacturing a drug. Still, the cost of the epinephrine dosage in EpiPens has been estimated by experts to be only several dollars.
But market forces can also play a big role in costs, he said, as when a drug company is devoid of real competition and there are no real "market countervailing pressures" for a drug company.
In this particular case of EpiPens, he said, one competitor left the market over "FDA issues." A competing pen, Auvi-Q is no longer available, and the FDA rejected another generic alternative to the EpiPen, according to the Times.
A generic alternative still exists – Adrenaclick – for a lower cost, Consumer Reports has noted.
Mylan has also pushed for its product to be in public schools as an emergency device. A federal law signed by President Obama in 2013 – which Mylan actively lobbied for – rewarded the states that mandated epinephrine injectors in schools. Mylan's program EpiPens4Schools provides several free pens per year for qualifying public schools.
Mylan announced last week that it was taking measures to supposedly make it easier for patients to obtain EpiPens. They said they were "doubling eligibility for our patient assistance program," so that "a family of four making up to $97,200 would pay nothing out of pocket for their EpiPen Auto-Injector." They also offered a "savings card" to trim costs by almost half for a two-pack of pens for those paying "full list price."
"We recognize the significant burden on patients from continued, rising insurance premiums and being forced increasingly to pay the full list price for medicines at the pharmacy counter," Mylan CEO Heather Bresch said in a statement.
Then on August 29, amid continuing outcry, the company announced that it would release a generic version of the product – containing the same drug and auto-injection function – for $300 per two-pack, half the price of the name brand version.
It is unclear whether the announcement will be enough to satisfy critics.
However, Hoadley said, Mylan's cost increase is a "symptom of some of the issues that we're dealing with" in the larger prescription drug market as a whole, where cost hikes of drugs have been linked by some to companies using "market leverage."
For instance, Martin Shkreli – former CEO of Turing Pharmaceuticals – made headlines after Turing increased the cost of its anti-parasite drug Daraprim from $13.50 to $750. Subpoenaed by Congress, he simply told members that he would "invoke my Fifth Amendment privilege against self-incrimination."
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Matt Hadro was the political editor at Catholic News Agency through October 2021. He previously worked as CNA senior D.C. correspondent and as a press secretary for U.S. Congressman Chris Smith.