Epipen CEO is Senators daughter that raised price from $100 to $600

[dmcowen674]

8-24-2016

Here's what you need to know about the CEO behind the big EpiPen price hikes


Mylan (MYL) CEO Heather Bresch is coming under new scrutiny for her company's decision to raise the price of lifesaving EpiPens more than fourfold over the past eight years.

For people who closely watch the pharmaceutical industry, Bresch is well-known. But among a broader audience, few people know who she is.

That is changing as Democratic presidential nominee Hillary Clinton , the American Medical Association and a number of U.S. senators are calling on Bresch to roll back the steep price hikes on EpiPens.

So, who is Bresch, and what is her backstory?

The CEO is the daughter of a U.S. senator. She reincorporated her U.S.-based drug company in the Netherlands, which cut its tax liability.

She also retroactively was awarded an MBA from West Virginia University while her dad was governor of that state despite not having enough academic credits. At the time, the university's president was both a former lobbyist for her drug company and a high school classmate of hers.

And Bresch has also overseen her company's increase in the price of EpiPens from $100 in 2008, to more than $600 for some customers today. During that time, her compensation has risen nearly 700 percent

When Bresch took over as CEO in 2012, Mylan's stock was trading at almost $22 per share. The shares are up 101 percent under her leadership. Revenue has risen 38.5 percent since she took over, to $9.47 billion at the end of 2015.

Bresch, 47, has been thrust in the spotlight in recent days after colleagues of her father Sen. Joe Manchin, D.-W.Va., in the Senate have expressed outrage about the stunning price hikes for EpiPen, a device that contains just a dollar or so's worth of the drug epinephrine.

EpiPens are used by people having an allergic reaction known as anaphylaxis, which can be fatal. People with allergies — or parents of children with allergies — are encouraged to have multiple sets of EpiPens for home, school and elsewhere. While insurance often covers some of the cost, many people have to pay out of pocket for the devices, sometimes up to the full price.

Clinton, a former senator from New York, on Wednesday called Mylan's price increases "outrageous," and "just the latest troubling example of a company taking advantage of its consumers."

"Since there is no apparent justification in this case" for the EpiPen price hikes "I am calling on Mylan to immediately reduce the price of EpiPens," Clinton said in a statement.

The AMA, the nation's largest doctors' group, earlier Wednesday said that "with lives on the line, we urge the manufacturer to do all it can to rein in these exorbitant costs."

Bresch, who has been CEO since 2012, did not return a request for comment from CNBC on Wednesday.

Neither did Mylan nor Bresch's father, Manchin, whose Senate colleagues are calling for hearings on the price of EpiPens, and one of whom, Sen. Amy Klobuchar, D-Minn., has asked for the Federal Trade Commission to investigate.

Employees at Mylan and a political action committee affiliated with the company from 2009 until 2012 contributed a total of $127,500 toward Manchin's special election to the Senate and then re-election in 2012, the second-largest amount of any single company toward Manchin, according to OpenSecrets.org. Records from OpenSecrets show that Mylan has given $72,543 to Senate and House of Representative members' campaign committees so far this year, but Manchin's more than $57,000 haul in 2012 from the company is more than five times the amount the firm gave to any other single candidate.

On Wednesday, Wells Fargo, in a research note, said that disclosure documents show that Mylan has been "actively lobbying" in favor of a bill in the Senate that would mandate that all airlines, domestic and foreign, carry at least two packs of epinephrine auto-injectors. EpiPens are, by a large degree, the most commonly used devices of that nature in the United States.

Mylan has spent a reported $875,000 on lobbying so far this year, after having spent $1.55 million in 2015, according to OpenSecrets.org,

On Tuesday, CNBC noted how Bresch's company, in addition to hiking the price of EpiPen by double-digit percentage amounts ever since Mylan acquired the device in 2007, has also been sharply raising the prices of other products this year.

In a research note in June, Wells Fargo had highlighted the fact that Mylan raised prices by more than 20 percent on 24 products, and by more than 100 percent on seven products. They include prices for generic drugs for common conditions such as gallstones (up 542 percent), gastroesophageal reflux disease (up 444 percent) and irritable bowel syndrome (up 400 percent).

As a result of the company's financial performance, Bresch's compensation hit $19 million last year, up from $2.45 million in 2007. Over the same period, an EpiPen's average wholesale price was being hiked by 461 percent.

Last year, Mylan, whose main offices are in Pennsylvania, reincorporated in the Netherlands, in what Bresch said was a defensive move against a possible takeover, but which also lowered the company's tax liability. Bresch's senator father Manchin is on the record as being opposed to tax inversions.

Even after that tax inversion, Mylan argued to the FTC that it should be treated like an American company for the purpose of U.S. antitrust regulations, which would have made it tougher potentially for Israel-based Teva Pharmaceuticals (Tel Aviv Stock Exchange: TEVA-IL) to acquire Mylan.

Teva launched a hostile takeover bid in April 2015 for Mylan. Teva dropped that bid in July 2015, and months later Mylan failed in its own effort to buy generic drug manufacturer Perrigo for $26 billion.

"We know the inversion has invoked a lot of emotional and political banter but the reality is we remain a U.S. issuer under all of the formal and informal guidelines," Bresch told the Bloomberg news service at the time, in June 2015.

Bresch, who started as a data entry clerk at Mylan, was named chief operating officer in 2007. As STAT News noted Wednesday, at the time she was promoted to that position, Mylan pointed out that she had a Master of Business Administration from West Virginia University, which she claimed to have received in 1998.

In fact, a Pittsburgh Post-Gazette newspaper investigation in 2007 said school records indicated that Bresch had obtained just 26 academic credits out of the 48 credits required for an MBA.

The paper found that WVU awarded Bresch her degree retroactively in 2007, after initially telling the newspaper that she never received her degree, and after Bresch insisted she had. Manchin was the state's governor at the time. The school, which had received more than $20 million in donations from Mylan's founder, claimed that Bresch had "completed all the requirements" for an MBA, except for paying a $50 graduation fee.

However, an investigation panel set up at WVU — whose then-president was Bresch's high school classmate and former Mylan lobbyist Mike Garrison — found that "Ms. Bresch did not earn an MBA at West Virginia University."

"The Panel finds further that the actions undertaken by WVU administrators in October of 2007 to determine whether Ms. Bresch had earned an MBA degree in 1998 and to thereafter modify her transcript were seriously flawed and reflected poor judgment," the panel said in its final report. "The Panel finds the rush to judgment in Ms. Bresch's case was driven primarily and inappropriately by concerns about public relations and by Ms. Bresch's high profile."

The university's senate overwhelmingly voted to compel Garrison to resign as WVU's president on the heels of the report. In response, he announced his resignation in June 2008, effective that September. A county grand jury later decided not to indict Garrison or anyone else in the MBA scandal.

That scandal has drawn renewed attention in recent days as controversy swirled over Mylan's EpiPen pricing practices.

Last year, Bresch told Fortune magazine, "I certainly to this day believe I did everything I needed to do to get my degree."

[dmcowen674]

Everything that is wrong with the U.S. and how the Corporations and the Government have been taken over in one article.

[RolloTheGreat]

Everything that is wrong with the U.S. and how the Corporations and the Government have been taken over in one article.

No.

How many pharmaceutical scientists do you employ Dave? What do you know about what it costs to bring a drug to market, insure your company against class action suits, and pay class action suits? How many times when they are trying to invent new drugs do you think they fail after spending 100s of millions on research? Do you realize they only get a certain number of years under patent to profit at all from their inventions, then they become basically free?"


The pharma industry isn't like, "McDonalds is selling Big Macs for $100 now and people need food to live!".

They are inventors in a costly industry. What their CEO makes is irrelevant. There are people who would do our jobs for less money as well.

I'm not saying there should not be regulation of pricing, I am saying that pharma is a different kind of business where the economics of say "wooden chair manufacturing" don't apply.

What is wrong with the US has nothing to do with pharma, and everything to do with the loss of living wage manufacturing jobs.

The "revolution" that needs to occur here to make things decent again is for government to work with industry to create that system again. Government needs to route all forms of public assistance to able bodied (AFDC, rent assistance, Obamacare) through manufacturing industries to subsidize people's wages rather than pay them to sit. Their labor would be partially self sustained by the profits on good sold, and provide employment for more skilled people upline, or less skilled along side of them. People with no or low skills would have hope for living wage jobs, our family structure would be supported.

A handful of CEOs making $100m a year isn't what ails this country, 40% of households having an average income of $32K/year is. (and no, there isn't enough money in CEO salaries to give those 40-50m workers the big raise)

http://www.taxpolicycenter.org/statistic...-quintiles

[RolloTheGreat]

http://taxfoundation.org/article/summary...e-tax-data

Notice how half the people in the country (bottom 50%) are only paying 11% of the federal tax and the top 10% are paying almost 60% of the federal tax?

Lots of pharma jobs are "good jobs" where the employees pay a lot of tax. Sure you want to dismantle that?

Basically the only reason pharma "works" is because some of the smartest people are willing to work there for big pay, and people are willing to risk investment in hopes of big profit if a necessary drug can be invented that can be sold for big profit.

No big reward, no medical advances. Smart and rich people will never waste their time for normal wages, they can do better.

If you and I had their skills or money, we wouldn't bother with normal wages either.

[dmcowen674]

You can't possibly be siding with the Pharma scum.

Did you read anything about that drug, anything?

It has $1.00 yes $1 dollar of the drug in it and the drug is nothing new.

What's new is the bitch giving herself a $90 million dollar raise.

If I didn't whole heartingly believe in free speech I would join the legions in banning your Corporate whoring ass to Internet pergatory.


But go right on showing the world your disdain for the common folk.

[SteelCrysis]

You can't possibly be siding with the Pharma scum.

Did you read anything about that drug, anything?

It has $1.00 yes $1 dollar of the drug in it and the drug is nothing new.

What's new is the bitch giving herself a $90 million dollar raise.

If I didn't whole heartingly believe in free speech I would join the legions in banning your Corporate whoring ass to Internet pergatory.


But go right on showing the world your disdain for the common folk.

[RolloTheGreat]

You can't possibly be siding with the Pharma scum.

Did you read anything about that drug, anything?

It has $1.00 yes $1 dollar of the drug in it and the drug is nothing new.

What's new is the bitch giving herself a $90 million dollar raise.

If I didn't whole heartingly believe in free speech I would join the legions in banning your Corporate whoring ass to Internet pergatory.


But go right on showing the world your disdain for the common folk.

Do you believe in capitalism Dave?

If so, what is she doing that is not in line with capitalism?

BTW- rather than say "This is a crime against humanity" I used Google to find the answer in about 10 seconds:

http://www.consumerreports.org/drugs/how...ternative/

People who don't want to pay $600 for the brand name can buy the generic for $140.

The only people I have disdain for is the able bodied who won't work, or think everyone should make equal pay.

I feel this way because I believe in capitalism, not communism or socialism.

I don't care if you ban me.I pretty much post wherever I like, and go figure- without the NVIDIA in my signature I never get banned. Weird, isn't it? Could there be some sort of correlation between the two?! It's a mystery!

[SteelCrysis]

The sheer fact that we have to turn to generic medicine is a bad sign. It's a dependency that could be yanked out from under us in the future.

[RolloTheGreat]

ma

The sheer fact that we have to turn to generic medicine is a bad sign. It's a dependency that could be yanked out from under us in the future.

Pharma is a different kind of business for all the reasons I mention, a little like NVIDIA and intel.

They have HUGE investment to bring a drug to market and only a brief window of time to profiteer on it.

The patents run 20 years, but they take about 8 years to get past FDA. So they get 12 years to put the screws to us, but they're doing super costly research and paying off lawsuits during that time as well.

And, since invention, or FDA approval, aren't guaranteed they are basically guessing how long the money from the 12 years raping us has to last. It's a strange business cycle, a lot like tech, but drug out longer and with more regs.

I'm still wildly oversimplifying the situation, and I don't like to pay a lot for medicine either, but I know there is more to it than "These guys have taken over the country and we are their serfs.".

So I try not to totally judge because I understand the upsides as well:

Lifesaving (or improving) medicines that someday become dirt cheap. The HCT I take for my blood pressure is so cheap I buy it without insurance. (think it's about $9 for 90 days)

All the investors (including retirees) who make bank off pharma and need the money.

All the tax dollars the employees pay that helps maintain the country.

The good lifestyle the employees families live, creating more good citizens who will be taxpayers. (statistically speaking my guess is pharma employee kids are way less likely to be burdens on society, success tends to breed success as the parents pass on advantage to their kids)

The families of merchants and service people who sell to the employees with more disposable. (like me paying some landscapers $2500 a few weeks ago to spruce up my gardens, or buying a new truck when mine had 17k miles on it the last two years- and I'm poor compared to a lot of pharma "scum")

People in general don't think about things deeply enough, and never consider how multifaceted and complex the economy is. They just point at stuff like this and hiss,"Robbers!" without even scratching the surface of the situation.

I don't like it that this woman cheated on her degree as I had to earn mine at considerable cost and effort, but I don't begrudge her the salary, and try to remember there are other factors in play I'm not an expert on before I pass judgement.

http://www.forbes.com/2002/05/02/0502patents.html

[RolloTheGreat]

What does she need a $90 million salary for?!

Take that off her and the price of Epipen would not need jacking up!

How can one man be so wrong, so often? Gosh GStan, if she worked for free for 30 years it would cover the cost of bringing ONE drug to market:

http://www.scientificamerican.com/articl...eeds-2-5b/

As usual, you think in small terms, your world.

 It has sweet fuck all to do with patent timescales and everything to do with unbridled capitalist greed.

https://hbr.org/2015/09/its-time-to-rein...cal-prices

The bottom line: most countries play hardball on drug prices, while the U.S. pays retail. As a result, consumers in the U.S. are stuck footing most of the bill for developing new drugs, even as consumers throughout the developed world reap the benefits.

The Harvard Business Review says we are paying for the drug development tiny little countries like yours benefit from GStan. Say "Thank you America" GStan.

http://www.forbes.com/2002/05/02/0502patents.html

Now, patents protect drugs from copycat versions for 20 years after the drug is invented. This is a bitter pill for pharmaceutical companies because it can take eight years or more after invention to accumulate enough data to get a drug past the U.S. Food and Drug Administration. Once the patent expires, 80% of the brand name sales can vanish within a year as generic competitors reach the market.

Yes Gstan, all corporate greed, things like costly R&D time compounded with time to bring a drug to market, pricing regs of poorer countries, and amount of time the drug can be sold at a high price has "sweet fuck all" to do with it.

It's probably just like you little computer shop. They could be adding 10% to the cost of each pill and doing just fine if they weren't so greedy!

And she thought she would get away with it all because Daddy is a big powerful senator who will cover her arse for her.

Gstan, Heather Bresch has a net worth of $27 million dollars, and a new salary of $90 million dollars. She's in her 40s. I don't think she needs her "daddy" for anything. She has more economic power than he does.

You're the same as most people Gstan, can't think beyond their little worlds, don 't understand that the big picture is much more complex.

[RolloTheGreat]

The company should be using the $90 Million for R&D and general expenses, not for paying the CEO an obscene salary.  That way the price wouldn't need to go up.

"Little countries" like mine (little only in terms of population - http://www.ga.gov.au/scientific-topics/n...e-compared ) invent many things the rest of the world finds useful. like refrigerators, pacemakers, Relenza (anti-flu drug), Gardasil (anti-cervical cancer vaccine) among many others.

https://en.wikipedia.org/wiki/Timeline_o...inventions

You think way too small for this market.

Last year Mylan made $2b profit on $9b revenues. Her $90m salary is less than 1/70th of their overhead.

[RolloTheGreat]

Those figures clearly demonstrate that Mylan had no credible need whatsoever to jack up Epipen prices except to satisfy the greed of their CEO.

CEOs don't act on their own. the Board of Directors, responding to the wishes of investors, guide companies. The CEO can make this kind policy on his/her own, but if it's unpopular with the board, it will change.

Are you enraged Titans now cost $1200, when NVIDIA's "best of best" used to be $500?

Should Jensen be fired for greed as he's worth $308m and making millions more every year? Think how cheap Titans would be if only they didn't have to pay Jensen.

[dmcowen674]

Jensen is making an obcene amount but he isn't in a position where his Company infringes on the lives and health of people.

[SteelCrysis]

Jensen is making an obcene amount but he isn't in a position where his Company infringes on the lives and health of people.

Did you mean to say "shouldn't be allowed to be in a position..." That's my view.

[RolloTheGreat]

Jensen is making an obcene amount but he isn't in a position where his Company infringes on the lives and health of people.

http://www.merriam-webster.com/dictionary/infringe

to do something that does not obey or follow (a rule, law, etc.) ( chiefly US )


2

: to wrongly limit or restrict (something, such as another person's rights)

Mylan hasn't broken any laws, and they will sell you as many Epipens as you want at their price.

A lot of drugs cost a lot. Until the rest of the world starts sharing in the burden of pharma R&D we'll keep on being ripped off.

If you want to be mad at anyone it should be people like SickBeast and GStan. Their national pricing regs force drug companies to rip us off.

Want to know how the price of Rx drugs on patent here could be lowered?

If pharma said "fuck you" to places like Australia and Canada and didn't sell there if they choose to regulate prices. The price of Epipens everywhere would probably be $150 if guys like the Australians didn't tell them, "You're allowed to sell them here for $75, $25 of which you owe us.".

[dmcowen674]

Jensen is making an obcene amount but he isn't in a position where his Company infringes on the lives and health of people.

http://www.merriam-webster.com/dictionary/infringe

to do something that does not obey or follow (a rule, law, etc.) ( chiefly US )


2

:  to wrongly limit or restrict (something, such as another person's rights)

Mylan hasn't broken any laws, and they will sell you as many Epipens as you want at their price.

A lot of drugs cost a lot. Until the rest of the world starts sharing in the burden of pharma R&D we'll keep on being ripped off.

If you want to be mad at anyone it should be people like SickBeast and GStan. Their national pricing regs force drug companies to rip us off.

Want to know how the price of Rx drugs on patent here could be lowered?

If pharma said "fuck you"  to places like Australia and Canada and didn't sell there if they choose to regulate prices. The price of Epipens everywhere would probably be $150 if guys like the Australians didn't tell them, "You're allowed to sell them here for $75, $25 of which you owe us.".

No, the increase in cost is squarely you and your criminal buddies fault.

The tide is rising though, you see more and more outrage.

That outrage will keep building until a tipping point.

You no doubt will be on the wrong side of that point.

[RolloTheGreat]

No, the increase in cost is squarely you and your criminal buddies fault.

The tide is rising though, you see more and more outrage.

That outrage will keep building until a tipping point.

You no doubt will be on the wrong side of that point.

Ever heard the saying, "'better the devil you know than the devil you don't" Dave?

If there ever is a "poor rise up and put anyone with designer sunglasses head on a stake" revolution, I hope you remember these conversations when you're risking getting shot every time you leave your home, starving, and sleeping with a gun in your hand.

Personally I can put hundreds of thousands in an offshore account on short notice and go somewhere the masses aren't insane, and my wife and I can work anywhere.

If the nightmarish Hell you seem to fantasize about ever came to pass, I'd be posting here from Switzerland.

[RolloTheGreat]

I'm curious Dave.

What exactly is it you want to happen in this revolution you've been forecasting for years?

Do you want everyone that seems "rich" compared to you killed so their assets can be stolen and redistributed to people who have less? Then what? Usually the people with the most money have skills that earned them the money, in your new world you're just going to do without software, engineers, doctors, lawyers, accountants, etc? Everyone will just make sandwiches, sweep floors, cashier, and the like but get paid big money to do it? Where will that money come from? What will the masses sell to other countries to generate wealth for your new world? Radishes?

Or do you plan to just kill "enough" successful people to frighten the rest to work for lower wages so the wages at the bottom can be raised? Do you really think the person who puts ham on bread deserves to make anywhere near the surgeon who fixes your heart? Based on what?

Do you think the rest of the civilized world would trade with this new "People's Republic of Bubba"? Based on what?
Their great need for things unskilled labor can produce? Or you think they would say, "Good for you! Make those smart bastards work for $10 an hour like they did you! We'll buy your goods just to teach them a lesson!"

I think it's basically a pipe dream. I don't think you have the stones to put people like me, Ben, Bofox in the guillotine and behead us in front of our horrified and weeping families "French revolution style".

"You have nicer cars and houses, you must die for learning better job skills"? This makes sense to you?

You really want people murdered just because they worked hard and figured out a way to make good money?

That is what you are talking about. Slaughter of innocent people and theft of their assets.

If that seems like a good idea to you, you don't need to ban me. I won't knowingly speak to blood thirsty criminals.

[RolloTheGreat]

Or is your revolution more sanitary, you don't have to dirty your hands with the murder of innocent people?

You just wake up and President Bubba is on tv saying, "Anyone with a car worth over $40K is now dead, the bodies burned. We will speak of them no more. Report to your city hall for your share of the plunder. You are now all CEOs, enjoy your new lives as rich people!".

You know what's different between then and now? The equal rights and opportunity the French fought for against their monarchy are the foundation of our country. We already have laws guaranteeing everyone the things the French fought for.

Almost everyone I know who lives in households where they have $100K or more income came from middle class backgrounds and worked their way into the positions they are in.

Is the basis of your revolution "we didn't take advantage of the same opportunities, so now we steal and kill"?

[BenSkywalker]

Yikes, where to start.

First off, real quick- Steel- you know that Oreos are generic? Hydrox are the original. In this instance we are dealing with highly specific chemistry, not culinary tweaking, generic medications should be just as effective as the name brands. 

Second point which it seems both sides are kind of missing in this discussion. This is not a 'capitalism' discussion. Capitalism is about making money- the particulars of this case are all about increasing stock valuations- it is an issue of corporatism. 

To that point, you all are on the wrong sides on your arguments here. See the problem in this particular case is that the US Government has handed Mylan the exclusive 'rights' for their Epipen solution. Because the government will only pay for Mylan's offering- the generic offerings are rarely stocked by pharmacies. In this particular instance we are now discussing the government forcing airlines to buy bulk quantities of this product all of which *must* be purchased from Mylan *instead* of its' lower priced competitors. 

Now the fact that the CEO's father *is* a US Senator(Democrat) and the government's procedures are exactly what put the market into the position it is in, I'm kind of curious of what this has to do with capitalism?

This is an issue of government manipulation and corporatism- period.

[SteelCrysis]

Yikes, where to start.

First off, real quick- Steel- you know that Oreos are generic? Hydrox are the original. In this instance we are dealing with highly specific chemistry, not culinary tweaking, generic medications should be just as effective as the name brands. 

Second point which it seems both sides are kind of missing in this discussion. This is not a 'capitalism' discussion. Capitalism is about making money- the particulars of this case are all about increasing stock valuations- it is an issue of corporatism. 

To that point, you all are on the wrong sides on your arguments here. See the problem in this particular case is that the US Government has handed Mylan the exclusive 'rights' for their Epipen solution. Because the government will only pay for Mylan's offering- the generic offerings are rarely stocked by pharmacies. In this particular instance we are now discussing the government forcing airlines to buy bulk quantities of this product all of which *must* be purchased from Mylan *instead* of its' lower priced competitors. 

Now the fact that the CEO's father *is* a US Senator(Democrat) and the government's procedures are exactly what put the market into the position it is in, I'm kind of curious of what this has to do with capitalism?

This is an issue of government manipulation and corporatism- period.

Wow, you're actually right for once, even though you think I need to be informed about Oreos. I appreciate generics–what I'm saying is that generics are going to be targeted for elimination by corporatism, and that this is a bad thing.

[RolloTheGreat]

Yikes, where to start.

First off, real quick- Steel- you know that Oreos are generic? Hydrox are the original. In this instance we are dealing with highly specific chemistry, not culinary tweaking, generic medications should be just as effective as the name brands. 

Second point which it seems both sides are kind of missing in this discussion. This is not a 'capitalism' discussion. Capitalism is about making money- the particulars of this case are all about increasing stock valuations- it is an issue of corporatism. 

To that point, you all are on the wrong sides on your arguments here. See the problem in this particular case is that the US Government has handed Mylan the exclusive 'rights' for their Epipen solution. Because the government will only pay for Mylan's offering- the generic offerings are rarely stocked by pharmacies. In this particular instance we are now discussing the government forcing airlines to buy bulk quantities of this product all of which *must* be purchased from Mylan *instead* of its' lower priced competitors. 

Now the fact that the CEO's father *is* a US Senator(Democrat) and the government's procedures are exactly what put the market into the position it is in, I'm kind of curious of what this has to do with capitalism?

This is an issue of government manipulation and corporatism- period.

This doesn't make sense. We're still primarily private insured, and HMOs strongly encourage generics. (by taking name brand off their covered list, much higher copays for name brand)

You'd think the high price, consumer demand, and insurance steering would make generic epipens stocked in every pharmacy.

Government manipulation of markets is reprehensible.

So Ben, will you be joining me in Switzerland when the people here decide we're evil incarnate for wanting a good lifestyle?

[RolloTheGreat]

Heh, maybe I'd join you in the outback if Dave goes all French Revolution here GStan.

Doesn't get any more "hiding out at the edge of the world" than your homeland, and everyone speaks the King's English.

[dmcowen674]

Here is more proof of Rollo's bullshit about Generics.

The Fox is in control of the Henhouse:

8-29-2016
Mylan To Launch Its Own EpiPen Generic Rival At Half Price

Embattled drug giant Mylan (MYL) said Monday that it will take the unusual step of launching a generic competitor to its own product, EpiPen, at half the price of the original.

Mylan spent last week defending itself against criticism from the Senate and from presidential candidate Hillary Clinton over its multiple price hikes for EpiPen, an emergency allergy treatment.

On Thursday, Mylan said it would expand patient assistance for EpiPen without actually lowering the price. But on Monday, it said that in the next few weeks it will release a generic version at $300 for a two-pack, compared with the current $608 price for the brand.

"Our decision to launch a generic alternative to EpiPen is an extraordinary commercial response, which required the cooperation of our partner," said Mylan CEO Heather Bresch in a statement, presumably referring to Pfizer (PFE), which draws royalties on the product. "However, because of the complexity and opaqueness of today's branded pharmaceutical supply chain and the increased shifting of costs to patients as a result of high-deductible health plans, we determined that bypassing the brand system in this case and offering an additional alternative was the best option."

Mylan also intends to bypass some of the system's complexities by launching a direct-ship program for EpiPen customers, potentially getting around some of the middlemen that Bresch said last week took cuts of most of EpiPen's list price.

Normally when generic competition threatens, the drug developer makes a deal with a generic drugmaker to sell the exclusive "authorized generic" for the first six months before other competitors can come onto the market.

However, since Mylan's main business is generic drugs, it can essentially be the generic partner to itself.

[RolloTheGreat]

Here is more proof of Rollo's bullshit about Generics.

(Boils down to: drug companies make money)

Who cares about that Epipen stuff?

I'm still waiting for you to straight out say you want to see my wife and I in the guillotine, beheaded for our crimes of working our way through college and then managing to work up to decent salaries.

You've said it more than once, how the new "French revolution" is coming and I'll be on the wrong end of it.

Why dance around it?

[BenSkywalker]

 We're still primarily private insured, and HMOs strongly encourage generics.

It's not quite a clear cut as that, a few different elements-

http://www.cnsnews.com/news/article/medi...or-workers

http://www.nbcnews.com/storyline/va-hosp...it-n101771

Combine Medicare, Medicaid, federal payroll and VA and we are looking at ~140 Million people who get their health care from the government.

So what we end up with is roughly half of the US populace is getting their health care under one set of criteria, where as those of us in the private sector have thousands of different sets. You and I could both have say, Blue Cross/Blue Shield and even pay the same premiums and have wildly different coverage. Maybe your plan is better than mine on say prescriptions, while mine may be better than yours on say ambulance services. Totally arbitrary but you get the point I am making. Looking at it from a straight business perspective, roughly half of all possible purchases are going to be one particular item while the other half are a hodge podge of various alternatives- if you own a pharmacy, which one are you going to keep on hand? These things have a shelf life, and inventory is sunk capital.

Another factor we have to look at is, in a general sense, mutual funds. If you have a fund that holds say $700 million in BlueCross/BlueShield, and they own $200 million in Mylan- from on overall bottom line perspective it is best to put pressure on them to only pay for the name brand, take that in conjunction with the US only paying for the same and you, in essence, dictate what everyone else must buy. This isn't precisely or necessarily an evil scheme hatched by mutual fund managers, just trying to illustrate how these things happen and to be fair, the fund managers *are* looking out for their customers best interests in such practices.

That brings us to another factor. Quick anecdote- my company swapped plans at the beginning of this year. We went to pick up a prescription for my kid and it was a $450 copay. It got interesting when I asked how much it was *without* insurance- $250. That isn't a joke(ended up being an error on the insurance companies part, I was refunded all but $10, my normal copay). So, I had to research this practice- turns out that large insurance companies buy into quantities of products not unlike the commodities market. They will negotiate and settle on a price for long term which gives them some level of financial stability, at a potential cost of reduced costs with market fluctuations. Mylan pulling a stunt like they are with Epipen could simply be them trying to leverage people into these sorts of long term commitments giving them a reasonable floor for revenue they can plan on.

So Ben, will you be joining me in Switzerland when the people here decide we're evil incarnate for wanting a good lifestyle?

Heh, you joke but where I live they have the 'Free State Project', pretty much a militia in the thousands that aren't far off from what Dave is talking about. Honestly, for the most part they seem to like me, they know exactly where I stand, they are a different branch of Libertarian thought than I am, but we are a *lot* closer then the mainstream for sure. Will anything ever come of them? Profoundly unlikely, at least in a revolutionary sense. These are people that have packed up from all over the country to move here and basically try to make sure that the voting block for traditional US values remains somewhere.

I did mention corporate greed and I did point out the undue influence of the Senatorial father....

Yes, but this 'attack' on the populace was done by the left wing for left wing purposes- this wasn't right wing nut job capitalists.

I appreciate generics–what I'm saying is that generics are going to be targeted for elimination by corporatism, and that this is a bad thing.

Their lawyers will try, but ultimately clearer heads will prevail. Push the pricing too far out of line for too long of a period of time and the regulatory powers that be will offer them up as a sacrificial lamb in a heartbeat to protect their positions. 

[RolloTheGreat]

 We're still primarily private insured, and HMOs strongly encourage generics.

It's not quite a clear cut as that, a few different elements-

http://www.cnsnews.com/news/article/medi...or-workers

http://www.nbcnews.com/storyline/va-hosp...it-n101771

Combine Medicare, Medicaid, federal payroll and VA and we are looking at ~140 Million people who get their health care from the government.

So what we end up with is roughly half of the US populace is getting their health care under one set of criteria, where as those of us in the private sector have thousands of different sets. You and I could both have say, Blue Cross/Blue Shield and even pay the same premiums and have wildly different coverage. Maybe your plan is better than mine on say prescriptions, while mine may be better than yours on say ambulance services. Totally arbitrary but you get the point I am making. Looking at it from a straight business perspective, roughly half of all possible purchases are going to be one particular item while the other half are a hodge podge of various alternatives- if you own a pharmacy, which one are you going to keep on hand? These things have a shelf life, and inventory is sunk capital.

Another factor we have to look at is, in a general sense, mutual funds. If you have a fund that holds say $700 million in BlueCross/BlueShield, and they own $200 million in Mylan- from on overall bottom line perspective it is best to put pressure on them to only pay for the name brand, take that in conjunction with the US only paying for the same and you, in essence, dictate what everyone else must buy. This isn't precisely or necessarily an evil scheme hatched by mutual fund managers, just trying to illustrate how these things happen and to be fair, the fund managers *are* looking out for their customers best interests in such practices.

That brings us to another factor. Quick anecdote- my company swapped plans at the beginning of this year. We went to pick up a prescription for my kid and it was a $450 copay. It got interesting when I asked how much it was *without* insurance- $250. That isn't a joke(ended up being an error on the insurance companies part, I was refunded all but $10, my normal copay). So, I had to research this practice- turns out that large insurance companies buy into quantities of products not unlike the commodities market. They will negotiate and settle on a price for long term which gives them some level of financial stability, at a potential cost of reduced costs with market fluctuations. Mylan pulling a stunt like they are with Epipen could simply be them trying to leverage people into these sorts of long term commitments giving them a reasonable floor for revenue they can plan on.

So Ben, will you be joining me in Switzerland when the people here decide we're evil incarnate for wanting a good lifestyle?

Heh, you joke but where I live they have the 'Free State Project', pretty much a militia in the thousands that aren't far off from what Dave is talking about. Honestly, for the most part they seem to like me, they know exactly where I stand, they are a different branch of Libertarian thought than I am, but we are a *lot* closer then the mainstream for sure. Will anything ever come of them? Profoundly unlikely, at least in a revolutionary sense. These are people that have packed up from all over the country to move here and basically try to make sure that the voting block for traditional US values remains somewhere.

I did mention corporate greed and I did point out the undue influence of the Senatorial father....

Yes, but this 'attack' on the populace was done by the left wing for left wing purposes- this wasn't right wing nut job capitalists.

I appreciate generics–what I'm saying is that generics are going to be targeted for elimination by corporatism, and that this is a bad thing.

Their lawyers will try, but ultimately clearer heads will prevail. Push the pricing too far out of line for too long of a period of time and the regulatory powers that be will offer them up as a sacrificial lamb in a heartbeat to protect their positions. 

I get that the government is a big customer, but I doubt the profits on Mylan stock outweigh the cost of epipens. If there is one industry that likes to take our money and keep it more than pharma, it's insurance.

I've got to doubt their accountants are saying,"If we pay $600 per epipen pack, we'll make back $10/share on our stock and it will be worth it". I think you'd have to show me the insurance companies own controlling interest in Mylan for your theory to ring true to me. (or why my guesstimate math is wrong with epipen sales vs stock dividends or price change are offsetting, to me it would seem for insurance to benefit they'd have to be buying few epis but raking in a lot of dividends or profit on stock sale)

No joke on "I am outta here" if the masses ever start killing the rich. They'll run out of them quick as there aren't many, and start looking my way and saying, "You are not of noble poverty, off with your head!".

First and foremost, I enjoy life and don't want to be executed for the crime of doing what every freaking person in the country should have done, take advantage of our educational system and opportunity to become an actual taxpaying citizen benefitting the country.

Second, economic upheaval like that would turn this place second world at best. The money printing $1000 loaf of bread banana republic would be hot on the heels of the revolution. Think about it- the only people who would revolt are the ones who haven't figured out how to make a good living here with all the opportunities available. You think they have some genius plan to run an economy as complex as ours?

There are definitely problems with profiteering in some industries, but I don't think some "good ol' common sense" is going to solve our nation's main problem:

The loss of protected markets coupled with the offshoring of low skill jobs has created a vacuum of living wage jobs for guys without technical training and skills. The less hope the poor have for a decent life, the more unrest we have on several fronts.

Post revolution President Bubba can't fix that by decreeing "Minimum wage is now $40 an hour!".

[BenSkywalker]

I get that the government is a big customer, but I doubt the profits on Mylan stock outweigh the cost of epipens. If there is one industry that likes to take our money and keep it more than pharma, it's insurance.

Total expenditures for medical in the US last year was ~$3Trillion. Total revenue for Epipen was $1Billion, globally. Just for the hell of it, we'll assume that every penny of Epipen revenue was from the US, that gives us 0.03% of total healthcare expenditures. I wasn't talking about the insurance companies volunteering, I was talking about the possibility of mutual fund managers leveraging them to do so. To give a rough idea, there are 1,810 billionaires on the planet holding a total of $6.5 trillion dollars in wealth(via Forbes)- Vanguard mutual funds handle $3.6 Trillion by themselves. They have more then half the wealth under their thumb of every billionaire in the world *combined*. Now if your company, hell- *any* company- had half of all the worlds billionaires telling them to do one thing that would negatively impact their bottom line by 0.03%- what company is going to say no? I just don't see it happening.

Take a five year swing and we are seeing the market capitalization of Mylan up around 300%, Anthem(parent of BlueCross/BlueShield) in that same time period is up about 100%. In absolute terms, Mylan has $23 Billion in market cap today, Anthem has $32 Billion in market cap. When looking at the largest factor, by *miles* in this instance, the difference maker in valuation is profit generation via Epipen(almost half of all of Mylan's profits).

In no way comprehensible am I trying to defend nor rationalize this- this is a function of corporatism. On the most basic level I am a lunatic *individualist*- I think people are best served having as much determination over themselves as is reasonable. Corporatism is directly aligned with communism in terms of ideological philosophy- centralization and financial engineering designed to serve the betterment of the corporation as a whole no matter the detrimental effects to the bodies involved. I am an ardent capitalist, but we are no longer operating under that philosophy, the markets have moved on, centralization has made maximizing profits secondary to RoI, improving the economic of your community, state or country now pales in comparison to expanding the economic conditions of the world. It is a shit show.

No joke on "I am outta here" if the masses ever start killing the rich.

Heh, you and I share a common bond in the fact that we play the game we are given. No businessman on Earth, no group of the 5000 richest businessmen on Earth can change what is happening with the world today, only the people who vote these people in can make the changes necessary. I don't particularly like checkers, never been a big fan of the game, never cared for the way the rules were structured nor how limited the options in the game were. That said, it has been a couple of decades since I lost a game. Whatever I am made to play, I'm going to try and do whatever I can to win(in the instance of my life, winning to me is a balance between how much I want to devote to work versus an acceptable level of income for my family).

[dmcowen674]

Thank you GStan and Ben for your posts.

[RolloTheGreat]

I get that the government is a big customer, but I doubt the profits on Mylan stock outweigh the cost of epipens. If there is one industry that likes to take our money and keep it more than pharma, it's insurance.

Total expenditures for medical in the US last year was ~$3Trillion. Total revenue for Epipen was $1Billion, globally. Just for the hell of it, we'll assume that every penny of Epipen revenue was from the US, that gives us 0.03% of total healthcare expenditures. I wasn't talking about the insurance companies volunteering, I was talking about the possibility of mutual fund managers leveraging them to do so. To give a rough idea, there are 1,810 billionaires on the planet holding a total of $6.5 trillion dollars in wealth(via Forbes)- Vanguard mutual funds handle $3.6 Trillion by themselves. They have more then half the wealth under their thumb of every billionaire in the world *combined*. Now if your company, hell- *any* company- had half of all the worlds billionaires telling them to do one thing that would negatively impact their bottom line by 0.03%- what company is going to say no? I just don't see it happening.

Take a five year swing and we are seeing the market capitalization of Mylan up around 300%, Anthem(parent of BlueCross/BlueShield) in that same time period is up about 100%. In absolute terms, Mylan has $23 Billion in market cap today, Anthem has $32 Billion in market cap. When looking at the largest factor, by *miles* in this instance, the difference maker in valuation is profit generation via Epipen(almost half of all of Mylan's profits).

In no way comprehensible am I trying to defend nor rationalize this- this is a function of corporatism. On the most basic level I am a lunatic *individualist*- I think people are best served having as much determination over themselves as is reasonable. Corporatism is directly aligned with communism in terms of ideological philosophy- centralization and financial engineering designed to serve the betterment of the corporation as a whole no matter the detrimental effects to the bodies involved. I am an ardent capitalist, but we are no longer operating under that philosophy, the markets have moved on, centralization has made maximizing profits secondary to RoI, improving the economic of your community, state or country now pales in comparison to expanding the economic conditions of the world. It is a shit show.

No joke on "I am outta here" if the masses ever start killing the rich.

Heh, you and I share a common bond in the fact that we play the game we are given. No businessman on Earth, no group of the 5000 richest businessmen on Earth can change what is happening with the world today, only the people who vote these people in can make the changes necessary. I don't particularly like checkers, never been a big fan of the game, never cared for the way the rules were structured nor how limited the options in the game were. That said, it has been a couple of decades since I lost a game. Whatever I am made to play, I'm going to try and do whatever I can to win(in the instance of my life, winning to me is a balance between how much I want to devote to work versus an acceptable level of income for my family).

I get mutual funds and other financial conglomerates exert influence, but even that is not all "bad". The people administering the funds have "good jobs", are "tax paying citizens that help fuel the economy". The investors in the funds profit along with them, this is what a modern day "pension" is. You invest your money along the way and hope to build up a million or two to supplement your Social Security. The funds investments help companies survive or grow, and in turn provide good jobs for other tax paying citizens.

It's not all just Bill Gates and Warren Buffet saying, "Meh, I want to make a few billion today and maybe buy Puerto Rico. Send a memo to that Bresch peon to hike the price of Epipens 500%!".

While corporatism on it's face may seem unequivocally ominous and evil, it "is" the game now as far as I can tell.

So I can try to position myself and my family to prosper within the game, or I can post,"Nuh uh. The revolution is a comin'! Someday soon we're all going to be CEOs and enjoying the bounty this land has to offer!".

I'm not going to do the latter for the same reason I don't live in an opium den. I don't like losing either, and maximize my enjoyment of life wherever and whenever possible.

[RolloTheGreat]

Thank you GStan and Ben for your posts.

Looks like someone has either reconsidered what a French Revolution here would actually mean, or you just have a hard time saying out loud, "I advocate the murder of people who have broken no laws and the robbery of their assets".

[RolloTheGreat]

I get mutual funds and other financial conglomerates exert influence, but even that is not all "bad". The people administering the funds have "good jobs", are "tax paying citizens that help fuel the economy". The investors in the funds profit along with them, this is what a modern day "pension" is. You invest your money along the way and hope to build up a million or two to supplement your Social Security. The funds investments help companies survive or grow, and in turn provide good jobs for other tax paying citizens.

It's not all just Bill Gates and Warren Buffet saying, "Meh, I want to make a few billion today and maybe buy Puerto Rico. Send a memo to that Bresch peon to hike the price of Epipens 500%!".

While corporatism on it's face may seem unequivocally ominous and evil, it "is" the game now as far as I can tell.

So I can try to position myself and my family to prosper within the game, or I can post,"Nuh uh. The revolution is a comin'! Someday soon we're all going to be CEOs and enjoying the bounty this land has to offer!".

I'm not going to do the latter for the same reason I don't live in an opium den. I don't like losing either, and maximize my enjoyment of life wherever and whenever possible.

What you are actually saying is you are every bit as greedy as the rich bastards and you don't care who you trample in life or how they are left to cope so long as you personally are ok....

Pretty good definition of a bastard IMO and definitely somebody the world is better off without.

"People who seem to have more money than me must die! Attack gorillas! Attack!"

-GCeasar, Livin' the dream

[SickBeast]

There has to be a balance here. There has to be a way for these drug companies to make a profit to pay for their R&D. And there has to be a way to ensure that the drugs are affordable for average people. They need to figure this out.

I will also say that something like an Epi Pen should be quite simple for someone to engineer at this point. I'm also pretty sure that there are competing products on the market that would probably do the same thing.

Actually the real solution would be for the USA to divert some of their military budget to help pay for disease research. Pretty much all of the world's problems could be solved if the US military budget was spent differently. Do that and crack down on all the tax loopholes and offshore bullshit. What the hell do I know though, I'm just an average guy. Crap like this makes me think about how parliament shuts down here in Canada every summer and I notice absolutely no difference in my daily life. We pay these people to make our countries better and they do nothing other than maintain the established order, which is essentially set up to keep the rich rich and the poor poor. You guys should read about the French Revolution.

[RolloTheGreat]

There has to be a balance here.  There has to be a way for these drug companies to make a profit to pay for their R&D.  And there has to be a way to ensure that the drugs are affordable for average people.  They need to figure this out.

I will also say that something like an Epi Pen should be quite simple for someone to engineer at this point.  I'm also pretty sure that there are competing products on the market that would probably do the same thing.

Actually the real solution would be for the USA to divert some of their military budget to help pay for disease research.  Pretty much all of the world's problems could be solved if the US military budget was spent differently.  Do that and crack down on all the tax loopholes and offshore bullshit.  What the hell do I know though, I'm just an average guy.  Crap like this makes me think about how parliament shuts down here in Canada every summer and I notice absolutely no difference in my daily life.  We pay these people to make our countries better and they do nothing other than maintain the established order, which is essentially set up to keep the rich rich and the poor poor.  You guys should read about the French Revolution.

A. There is a way for drugs to be cheaper in America and have R&D. All you people in countries that legislate the price of drugs be dirt cheap start paying your fair share instead of expecting Americans to pay for it. My guess is your solution is more along the lines of "Wah. Why can't we make the government steal money from rich people to pay for it. Wah. They have plenty."

B. If I didn't know middle class people who were good and decent people, I would swear that not having a lot of money makes people bloodthirsty murderers based on what I see on this board. You should be ashamed Dave, SB, and GStan. Wishing for people to be killed and robbed just because they have more money than you is about as childish, ugly, brutish, and reprehensible as it gets.

I've got news, unless you're Bill Gates or Warren Buffet, you know plenty of people who are richer than you are, some much richer. The rest of us don't slink around like the Gollum in LOTR hissing, "They have my PRECIOUS!! We kills them and TAKES THE PRECIOUS!!!"

Grow up. Be a fucking man. If you want more money, switch jobs, or get training that will earn you more money.

Or better yet, be happy with what you have, which I consider the true key to life.

When my wife and I bought our first home we made a third of what we do now and my dad had to loan us the down payment. When we bought our third home we didn't need to "save up a downpayment" or even sell our first house. We're no happier today than we were then, not one bit.

The only things that have mattered at all in my life are marrying my wife, the addition of our son to the family, and the time I've spent with family and friends.

You dumbasses need to be thankful for what you have, and stop dwelling on what you don't. Life is too short for regrets and wishing for what you don't have.