Combopen Ethical

As a critical care nurse the concern with medication shortages really hits home. In my current practice I have been asked by our hospital pharmacy to decrease the amount of Ativan given to a patient because the supply was low and they did not have any more to restock our omnicell. I am unsure the reason behind this particular shortage, but several other drugs we currently use are in low supply, most importantly epinephrine. Epinephrine is a life-saving medication, not only for supply on our code carts for cardiac arrest, but available in injection form for people with severe allergies. The shortage affects everyone, from oncology patients to cardiac patients. Recent policy changes have been made in order to correct the major shortages to help keep these life-saving drugs on the market and available to the people that need them.

The pharmaceutical industry is one of the most powerful and greedy industries in our country, with a goal to make as large a profit as possible, at the expense of the sick.

The current debate over the Mylan Company’s near monopoly of the epinephrine market through its EpiPen shows what can happen without monopoly regulation. While the cost to produce an Epipen is around $30, the price to the consumer is around $300 each. The economic implications for a family that needs to keep the device on hand to save a life can be excessively high, the emotional results of not having one when you need one are debilitating. This monopoly is further enhanced by state-enforced regulations requiring that schools keep EpiPens in stock and the, so-called, EpiPen law enacted in 2013, which leave little incentive for other pharmaceutical companies to develop their own technology for fast-acting emergency devices. (Bartolone, 2016) Breaking Mylan’s monopoly will not only lead to new product development but lower prices for consumers for a life-saving delivery

In 2015, the pharmaceutical industry spent over 27 billion dollars on advertising. The two greatest components of this effort were promotional advertising and free medication sampling, which the pharmaceuticals invested 15.5 and 5.7 billion dollars respectively (“Persuading the Prescribers”). Promotional advertising involves direct contact with health professionals, the most common being extravagant lunch conferences held for physicians and their staff. On the other hand, sampling involves distributing free sample of medications to physicians, who then have a choice of providing these samples to patients. As a result of these methods, the industry has seen revenue around $400 billion with 90% of physicians having a relationship with a drug company (Campbell 2007). Moreover, the prices of prescriptions continue to rise; a copay of a generic drug is $11.72, preferred brand drug is $36.37 and a specialty drug is $58.37 (Coleman and Geneson 2014). Although the profits are immense in the numbers demonstrated above, it is no surprise when pharmaceutical drug companies elevate their prices even more. For instance, recently Turing Pharmaceuticals raised the price of their medication Daraprim from $13.50 to $750. Keep in mind, this medication is used for threatening parasitic infections, aids, and cancer with alternative options currently found to be inefficient (Pollack 2015). Another example of this practice involves cycloserine, a drug used to

In the article “Mylan Faces Scrutiny Over Epipen Increases,” by Jonathan D. Rockoff, the product of EpiPen is discussed, along with Mylan’s incentive to increase price, and the public and governmental backlash to this price increase. EpiPen is a lifesaving, emergency, allergy treatment that keeps those who have extreme allergic reactions from going into severe shock. It is used by millions of people, including many schoolchildren. A pack of two costs $608.61, which is up 548% since 2007, as the product has had 17 price increases over the years, according to Truven Health Analytics. Over 3.6 million prescriptions for the product were written last year, according to IMS Health.

The EpiPen device automatically injects a drug called epinephrine, which reverses potentially deadly allergic reactions. It is the only device of its kind available in the United States. Millions depend on carrying the device at all times. For decades the EpiPen was available at a low cost until the Mylan Company purchased it in 2007. Since then, the price has risen over 400% creating a public backlash of media reports, social media petitions, and politician’s calling out Mylan executives to explain the reason for the price raise. Lack of compassion and appearance of greed has tarnished the public image of the company. Mylan has begun looking for ways of rebuilding their image by releasing compensation to the public in the form of generic cheaper EpiPens and payment assistance to eligible patients, but it might be too little too late in this current ongoing communication crisis event.

Recently, there had been a controversy over the rise in pharmaceutical costs involving the EpiPen in the United States. The EpiPen, also known as adrenaline/epinephrine, is a widely used injection that is used to treat allergic reactions. This generic drug has been available for many years. The EpiPen controversy is a prime example of how monopoly

In contrast to the newer prescription drugs, already existing prescription drugs cumulatively increased 81% from 2005 to 2013. Of these prescription drugs, the ones that treat chronic conditions have had a price increase of $4,336 in 2006 to $11,870 in 2013. These high price points on drugs that have been on the market for several years are a significant factor in the accelerating prescription drug inflammation. An example of rise in existing prescription drugs is Jazz Pharmaceuticals' Xyrem, a drug which purpose is to treat narcolepsy, was in 2007 priced at $2.04 per 1-milliliter dose. In 2014, Jazz Pharmaceuticals' Xyrem was priced at $19.40 per 1-milliliter dose. This means that there was 841% price increase over the course of seven years on the same exact drug. Jazz Pharmaceuticals' is not the only company increasing its prescription drugs in such high amounts. Eli LIlly had a price increase of 350% over the course of 6 years from 2007 to 2013, and Mylan hiked its epipen cost that treats anaphylaxis by 220% in the same six years. Companies say these costs are higher due to a number of reasons. One being that the high costs of these prescription drugs are being used to help find more efficient cures to disease, saving money in the long run. Another being that everything in our economy is inflating so it is only natural that prescription drugs increase as well.

"The pattern of large, biannual price increases for EpiPen began in 2009. In an earnings call that year, Bresch, Mylan’s chief executive, told investors that the company would be introducing a new version of EpiPen’s autoinjector device, one with patent protection that would make it more difficult for a generic competitor to enter.

The EpiPen, manufactured by Mylan, has been around for years. This auto-injector medical device, filled medication known for saving individuals having life-threatening allergic reactions, is utilized all over America, in schools, workplaces, and in the homes of many. As the demand for the EpiPen has steadily increased, so has its price, rising dramatically from less than $100 to over $600 in under a decade. My question is: With such high increases in price, how has the EpiPen been able to remain successful in the pharmaceutical industry?

EpiPens are arguably one of the most important devices for those to carry who suffer from life-threatening allergies. The auto-injector pen contains the drug epinephrine, which treats an allergic reaction, anaphylactic shock, in emergency cases. Recently, there has been an uproar among the public about the increasing prices of Mylan’s EpiPens. In 2007, the products cost was around $100.00 for a two-pack of pens. Now, however, the name brand is selling for over $600.00 a pair; resulting, in a 400% price increase. Different companies are now creating similar products in hopes of being more affordable and as efficient as the original EpiPen. Mylan Pharmaceuticals is even creating their own version of an authorized generic form of the EpiPen as well. In the first article, “Mylan Tries Again to Quell Pricing Outrage by Offering Generic Epipen,” by Andrew Pollack, focuses on just Mylan 's version of their EpiPen along with their increasing prices. The second article, “Can You Get a Cheaper EpiPen,” by Ginger Skinner, emphasizes on not only Mylan 's’ product, but also other generic products as well as a do-it-yourself. Both of these articles focus around the idea of an affordable, effective, and accessible off brand version of the EpiPen while also providing important side information about all of the products and risks; however, the second article offers more information about different generic products rather than just

A lot of people, particularly the patients who need them, are beginning to wonder why American drug prices are so high. It makes sense why the pharmaceutical companies are selling at the prices they do: they are a business; and they want to, above all else, make a profit. But the real question is: what are all of the

The device that was later called the EpiPen, an auto-injector with the intended purpose of delivering a precisely calibrated dosage of epinephrine without medical training, was created in 1974 and used by U.S. soldiers as a way to quickly treat poison gas symptoms on the battlefield. It was later approved for use with epinephrine, the trade name for adrenaline, for anaphylaxis. The manufacturer who gained the approval in 1987 was acquired by Pfizer and they sold the rights to the device to Merck. Mylan Pharmaceuticals purchased the marketing rights to the EpiPen in 2007 which at the time, cost about $57 each. Today EpiPens inflict pain on the patient who needs them with a price tag of more than $600 per pack of two. This is an increase of approximately 550 percent over a nine-year period. The cost of the device has become the object of intense scrutiny partially because it contains about a dollar’s worth of epinephrine which is used to treat anaphylactic shock and also because Mylan has a virtual monopoly on the device itself. Some experts claim the device known as the EpiPen costs only about four dollars to make. (Anaphylactic shock occurs when a person has a severe allergic reaction to a food or insect bite.) This is only the most recent in a series of similar events involving pharmaceutical companies. Mylan now finds itself under a very bright spotlight and is being held up as an example of “Big Pharma” taking advantage of those in need and an

This source should be considered credible as it comes from a well-respected news outlet, The New York Times. The author can also be considered an expert in this field as she is a non-practicing doctor. Another reason this source can be considered credible is due to its use of factual evidence straight from the primary source to explain the cost of drugs right now. An example of this is when Rosenthal quotes Juan Carlos Molina, the director of external communication for GlaxoSmithKline, the company that makes Advair, who states “a medicines price is closely linked to this country’s model for delivery of care”(Rosenthal). A limitation to this article pertains to the fact that it primarily focuses on Asthma medication. While this may limit the relevancy of the article's argument, there is still a clear price increase for other drugs in today’s market as well, which is expressed clearly by Rosenthal. I will use this article to provide context regarding the cost of drugs

In a New York Times article, “EpiPen Price Rise Sparks Concern for Allergy Sufferers”, there were interviews with parents who need to purchase this medication for their children. One woman, Lauren Barr said her copay rose from $141 to $245 in a year, and that she would spend $735 for three EpiPen sets for her 6 year old daughter. With this medication, those with high-deductible healthcare plans are more likely to see the price hike than those with plans that have lower copayments. The most surprising story was Sarah Brown who was unable to afford her $585 copayment, and had to hold onto her expired EpiPens. The Average Wholesale Price (AWP) of the drug Epinephrine, the active ingredient in EpiPens, per 1 milligram per vial is $2.52, whereas the AWP of the EpiPen is $730.33 and the AWP of the generic product is $494.01. Recognizing the need for a less expensive Epinephrine auto injector, CVS is offering Adrenaclick for $110.00 per 2 pack, exhibiting a free market approach to the health care