Let's Talk about EpiPens for a Minute

Everyone right now is in an uproar about EpiPens, and there are a lot of understandable reasons for that. For parents of kids with severe allergies (an ever growing population for reasons that are still the subject of some scientific dispute), EpiPens can be a literal life saver. I don’t know a single parent of a kid with allergies that does not have an EpiPen in the house.

It used to be that EpiPens were relatively cheap to purchase, even without health insurance, because they had a competing product. However, all those competing products were recently yanked off the shelf due to a product recall, giving Mylan, the maker of EpiPen, a temporary window in which they had a monopoly on an emergency life-saving drug. Mylan responded by upping the price of EpiPen to about $600 for a pack of two doses; a price that is cost prohibitive for many households.

But Mylan did work aggressively with insurance companies to keep co-pays down for patients who have prescription drug coverage. The end result is that the only people who have even noticed the increase in price are the uninsured, or the insured who do not have separate prescription copay coverage. In other words, the very people least likely to be able to afford EpiPens out of pocket (at $600 a pop).

So, you know, on this set of facts, people are outraged, and you can kind of understand why. Keep in mind, I am an avid promoter of the right of pharmaceutical companies to charge huge amounts of money on drugs when they are in the initial patent phase. I’m a near-total capitalist for one thing, but for another thing, I kind of like the fact that pharmaceutical companies can continue to fund at least some portion of their R&D off their own profits instead of entirely off the government teat.

And I am in favor of Mylan taking advantage of this market situation (which was not their own creation) and make a tidy little profit. Wait, let me rephrase: I’m in favor of Mylan being allowed by the Government to take advantage of this market situation and make a tiny little profit. In the absence of a natural or legally-created monolopy, I am of the firm belief that the government has no business declaring outright how much is “too much” for a given product to cost. And I am of the opinion that legally-created monopolies should not exist, except where natural monopolies otherwise would anyway.

I’ll tell you what should happen, though, and that is that people ought to remember this behavior on Mylan’s part when, in the future, they are considering their future pharmaceutical needs. Believe me, your physician will not prescribe you a product if you flat out tell them, “I don’t want to take any Mylan products,” especially if there is any feasible alternative. They might explain to you their opinion as to why the Mylan product is better, but if you hold your ground they will prescribe you something else. And if they won’t, well, there are lots of physicians in the world today.

Inviting the coercive power of the government into a situation ought to be a rare occurrence and limited to those occasions where the coercive power of collective societal outrage and accompanying financial boycott won’t adequately punish the guilty. Murder is one such occasion. Theft is another. But the other examples are much further and fewer in between than our modern criminal (and civil) code suggests.

I know what some will say, “But Leon, Mylan is killing those kids, aren’t they guilty of murder?” No, they are not. Mylan does not have a legal obligation to save those kids’ lives. They don’t have an obligation to make EpiPens at all, much less do they have an obligation to make that product available to anyone at any given price, regardless of whether it saves lives or not. And if they did, where would it end? If a mom can’t afford $50, does EpiPen have to make one available to her at $40? What about if a mom can’t afford $20? Or $1? Does everyone who makes a product that might enhance human health have an obligation to give it away for free to anyone who can’t afford to pay for it?

I don’t think so – and what I mean by that is that I don’t think they should have a legal obligation to do that.

Now, on the other hand, do I think they have a moral obligation not to profiteer off a drug that is easily manufactured and is at present the only option to quickly save a kid in the middle of a severe allergy attack? Yeah, I do. And the way I think the violation of that obligation should be punished is with people refusing to purchase Mylan products, if they share my conviction that this behavior is wrong.

Inviting the government into this door just brings us one large step closer to the 1984-style dystopian totalitarian regime towards which we seem to be inexorably creeping. We ought to resist the impulse to bring the fist of the government down on everyone who angers us, as often as we can. Otherwise, eventually, we’ll all find ourselves crushed by it in the end.


Addendum: Let me tell you about another bonus that’s been brought to your life by the miraculous intervention in the practice of medicine known as Obamacare. As part of I guess theoretically helping consumers, the FDA began a process of reviewing medicines and medical devices to re-determine whether patents were necessary and serving the public interest. Guess what, the FDA started determining that medicines and treatments that were previously sold without a patent now suddenly required a patent. The end result of this process is that many medicines that used to be dirt cheap are now ridiculously expensive thanks exclusively to Obamacare. Just a helpful reminder about what happens when the government starts messing with prices – it almost never works out for consumers in the end.

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