In 2015, when Martin Shkreli (CEO of Turing Pharmaceuticals) hiked the price of Daraprim (a drug used in the treatment of HIV) from $13.50 per pill to $750 (5,000% more expensive than its original cost), Mark L. Baum (CEO of San Diego-based Imprimis Pharmaceuticals) developed a $1 alternative to the life saving drug (and still made profits).
In 2007, when Mylan Pharmaceuticals acquired EpiPen (an epinephrine auto-injector used in the treatment of life threatening allergies and bee-sting emergencies) and hiked the price from a little over $100 to $600 in 2016 (a 500% increase for a one-year, two-pack supply), Jeremy Counts (owner of Main Street Pharmacy in Blacksburg, Virginia) promptly challenged the greedy generic drug manufacturer with a $20 alternative.
“I buy the epinephrine in bulk and I get a good price and then I take the syringes and I pre-load them with 2 doses for people, and after I pre-load them, they’re ready to go. There is absolutely zero difference as far as the actual medication being delivered. The only difference is they’ve got a fancy pen with a spring in it.”
The only major difference between Count’s pens and Mylan’s EpiPens is that his alternative lasts about three months in storage while EpiPen lasts a year or 18 months maximum.
Enter Mark L. Baum.
Disgusted at Mylan’s decision to gouge the patients (considering the main ingredient, epinephrine, costs only a few dollars without the auto-injector), Baum is developing a customizable and compoundable alternative to EpiPen for less than $100.
Meanwhile, Dr Douglas McMahon from the Allergy and Asthma Center of Eagan, Minnesota, has created a cheaper and more compact epinephrine-delivering device — dubbed the AllergyStop — which he intends to sell for about a tenth of the price of EpiPen. Dr Douglas has already started crowd funding a $50 version of the EpiPen on IndieGogo with a $200,000 goal to complete quality testing and gain FDA approval. He told CBS Minnesota:
“I’ve been working on this for many years. I actually have severe food allergies myself, so I’ve needed to carry an Epinephrine device for many years. Throughout that process I’ve realized the current device [EpiPen] is really big and cumbersome, to the point where I hardly ever carried it. By chance I came to realize how inexpensive the parts were, including the medicine, and I realized we can sell it to patients for a very reasonable cost.”
San Diego-based Adamis Pharmaceuticals is also working on a pre-filled syringe system for injecting epinephrine, an alternative that will cost at least 40% less than the current market price for a one-year, two-pack supply of EpiPen. The product is currently under review by the FDA, and the company expects to start selling it in 2017.
Massachusetts-based Windgap Medical is also trying to get FDA approval for Abiliject, an EpiPen alternative that will have a shelf life of several years, making it more cost-effective than EpiPen. Abiliject, a device that won’t degrade when exposed to light or extreme temperatures, is about the size of a Bic lighter — less than half the girth of an EpiPen — so Windgap’s co-founder and CEO Christopher Stepanian believes users will be more likely to carry it with them at all times.
Two other EpiPen alternatives — the credit card-shaped Adrenacard, which can be stocked in one’s wallet, and a generic auto-injecting system from Teva Pharmaceuticals — are also in the works and could be available to consumers as soon as 2017.
But how did Mylan Pharmaceuticals get away with a 500% price increase in the very first place? Because it has a monopoly, writes Forbes, one that is maintained by the federal government’s own regulatory scheme which allowed, in fact encouraged, a billion-dollar market to be cornered by one supplier.