In 2007, the pharmaceutical company Mylan acquired the rights to the EpiPen, a drug delivery system that relieves individuals from some of their worst allergy symptoms. EpiPens contain epinephrine (adrenaline), which is commonly used to counter anaphylactic shock brought on by allergic reactions. When Mylan first purchased rights to the EpiPen in 2007, a two-pack cost around $100. As of September 2016, a two-pack costs roughly $600 — a 500 percent increase.
Many individuals with severe allergies, including Fordham students, were shocked at what some consider to be price gouging. “It’s kind of scary to realize that companies, like Mylan, can make the price of life-saving treatments so incredibly high,” said Megan Czachor, FCRH ’18. Czachor suffers from a tree nut allergy, meaning that cashews, coconuts, pistachios and many other common ingredients can send her into anaphylactic shock. Like many other allergy sufferers, Czachor is equipped with an EpiPen, which provides her with “reassurance of immediate, necessary treatment” in the event of an allergic reaction. Czachor believes it is “horrible” that a large population of people can no longer afford EpiPens, which she refers to as a “life-saving treatment.”
Some allergy sufferers take a different stance on the Mylan controversy. John Furlong, FCRH ’18, suffers from a dairy allergy and carries an EpiPen. While he is disappointed that the price of a drug which is “so necessary to so many people” can be driven up, he believes the brunt of the blame should be placed on the government instead of Mylan CEO Heather Bresch. “As the CEO of a company, it’s [Bresch’s] job to make money. While it may not be morally right, it’s her job. The government should take much more responsibility, as it’s their job to regulate things like this,” Furlong said.
Emergency medical services are already feeling the blow from the price increase, including Fordham University Emergency Medical Services (FUEMS). This student-run organization is granted an annual budget from the University. However, according to Heather Cahill, FCRH ‘18 and chief of FUEMS, it is a “relatively small budget” compared to that of other agencies. While other agencies have an charge $750 to $1000 per call, FUEMS does not. “All of our equipment, medications and supplies are provided by us,” said Cahill.
FUEMS’ ambulances carry one adult EpiPen, and one pediatric EpiPen, with an additional two spares of each in the supplies room. Epinephrine loses its potency after approximately 12-20 months, which means that EMS agencies potentially spend thousands of dollars a year on using and replacing EpiPens.
Epinephrine is a relatively inexpensive drug: a 30 mL vial (100 doses for an adult, 200 doses for a child) costs around $75 on the emergency medical supply company, buyemp.com. The cost disparity between epinephrine and the EpiPen is in the delivery system – readying and use of an EpiPen is faster than the dose measuring and syringe-and-needle administration necessary for drawn-up epinephrine. However, many EMS agencies are turning to the drawn-up method of administering epinephrine, as opposed to the EpiPen.
The Monroe-Livingston Regional EMS Council has implemented a pilot program for drawn-up epinephrine in New York State, called “Check and Inject” At the moment, FUEMS is unable to use the Check and Inject method of drawing up epinephrine, but they are hopeful that many more EMS agencies can turn to this alternative in the near future.
“I think check and inject is a great movement for the EMS world…though it’s not quite as easy as the standard EpiPen, it isn’t very difficult. It’s similar in a way to a diabetic who has to take insulin every day,” Cahill said.