EpiPens aren’t the problem.

(For those few of you who’ve been living in a cave in northern Nunavut for the past ten days, you might have missed Ben Popken’s story on the EpiPen price gouge.  Go read it, then come back and join the rest of the class.  Slacker.)

I’m going to call “bullshit”. Once again, the American Media, courtesy of political campaigns, is indulging the American Media Consumer — blinkered, pig-ignorant, and proud of it — in a pointless round of outrage at nothing.

Look, the basic problem isn’t the damn EpiPen, or that some CEO got a raise of $18 million. It’s that we have a system where people make a profit from other people being sick, and nobody is even remotely interested in changing it. Let’s get that out there and leave it lie, because that’s what I’m outraged at, and I think it’s what you should be too.

The EpiPen is important, and a lot of poor people can’t afford it.

But this story? This is nothing. And it’s a nothing that was turned into a media firestorm by politically-motivated Senators in order to outrage the voter and swing their votes, instead of addressing the underlying societal sickness. The politics here is what I find truly despicable — but I’ll get to that; back to the EpiPen.

The news story boils down to “Drug Corporation Raises Prices Yet Again”.  Which, as we all know, is not news.  News is something NEW; it’s not “Dog Bites Man”, it’s “Man Bites Dog”.

This particular increase in price is normal and justifiable from a business perspective.  It came about due to a persistent lack of generic alternatives. The market will correct itself within the next few months, but the present generics are all sub-par. ALL of them. The formulas don’t work; the injectors are crappy — whatever the basic cause, the competition sucks. Which is insane, because this is a very simple product that’s been around for fifty years.

The price increase is, in a very real sense, perfectly appropriate for the situation, since it’ll pay the competition to develop a decent generic alternative.

The down side is, the FDA, being a legendarily inefficient hidebound bureaucracy, will delay release of the replacement generics for years. This process is inefficient largely because, over time, Congress has reacted to American voter indignation to one thing and another not by fixing problems but instead by increasing the regulation on the FDA until it has become a barrier rather than a help. And that’s part of what we should really be outraged about, not the price hike.

(Don’t blame Ben Popken, the writer of the original article.  In it he did quote a guy who’s been putting his own generic through the FDA process for the last three years.  Apparently, it works fine and costs a tenth what the brand name one does — except, since the inventor is an MD and not a mass production expert, I’m going to take that claim with a grain of saline drip.  Anyway, that factoid got lost in the subsequent media firestorm.)

Was the EpiPen developed using taxpayer dollars?

Well, there was an Army-made autoinjector before there was one designed corporately. It didn’t deliver epinephrine. It was somewhat similar in concept to the present EpiPen, but that design is pretty basic and easily copied and recreated without breaching copyright. Any decent engineer could manage it.

But, look, admittedly the EpiPen was based on a simple idea that the military developed as chem warfare treatment. Fine so far. But that military injector cost thousands per unit because it was designed for the military, for soldiers to use in combat. The EpiPen was designed for schoolkids, safety, and mass production. It’s a completely different thing. It could be more different, but then it would be a type of lingerie designed for cats or something. The modern EpiPen and the original military device have needles; that’s about it.

And nobody holds a patent on epinephrine, either. That’s a natural compound.  Someone isolated it a hundred years ago.  You might know it as “adrenaline”.

The fact of the matter is, there’s only one decent quality device produced in the USA. And there could be others, except the competition keeps screwing up the formula or the pen, so every generic is quite legitimately banned on grounds of safety or too crappy for people to bother with. The off-brand Auvi-Q is the perfect example; it was just recently recalled because of dosage irregularities on the production line, and that’s what indirectly led to the recent price hike.  (NOTE:  I’m not a medical expert; the preceding is just opinion.  Don’t sue me, Big Pharma; I’m an impoverished writer.  I have no money.)

And yes, the CEO of Mylan Pharmaceuticals did indeed have an $18 million wage increase.  She earned it by being damned good at her job, which at the time was convincing us that we need EpiPens.  Not that they’re not useful lifesaving devices, you understand, but until she sold us on them, we had no idea we needed them in the first place.

So, all in all, this is yet one more media firestorm generated from– well, not from nothing. But the true story, the intrinsic sickness in the American pharmaceutical complex, is being hidden behind the easily understood and often spun myth that Big Pharma is greedy and CEOs are rich.

The truth is:
– Big Pharma is no more greedy than any conscienceless corporation run by executives with MBAs rather than MDs.
– (Side note: MDs are notoriously horrible at running corporations. This is because they’re trained to fix humans, and MBAs are trained to manage businesses.)
– Big Pharma has to pay a shit-ton to Big Insurance because Americans love to sue Big Pharma for having accidents. Which any vast industry has happen, no matter how cautious.
– Big Insurance is increasing prices to pay for the hit they’re taking on the Affordable Care Act, which isn’t any more affordable than it was before but instead differently regulates who pays for things.
– CEOs make a lot of money, but an $18 million raise is nothing compared to the income generated by EpiPen sales, and the EpiPen is only one product.

The worst part of this, the most villainous nastiness that’s come out of the situation, is the oft-repeated idea that the problem can be fixed if you just vote right this November. Which is NOT TRUE. It’s not just a lie; it’s a damned lie — because this problem and those like it are never ever solved by voting right in November.

There is no candidate or political party that cared about this ten days ago. Bernie Sanders jumped on the bandwagon and then everyone else did too, but that doesn’t mean a candidate that rants about the EpiPen today is gonna fix the problem. Not even Bernie could do that, even if he were still running for President.  Obama rammed a massive overhaul of medical insurance through Congress, and all that did was make one third of the country virulently hate a second third of the country about something nobody really understands.  The reason I know that nobody understands it is that the arguments pro and con have nothing whatsoever to do with what the Affordable Care Act actually does.

It’s not the deadlock in Washington that’s the trouble here, people, and it’s not corporate greed. It’s that the ACA doesn’t address any part of the system that’s actually causing a problem. It’s a meaningless vote-getting palliative, just like every other proposal that is ever offered on the issue. No amount of reforming can possibly change that.

You see, the ACA doesn’t change the cost of healthcare. It impacts the price, and who pays. The actual cost, in terms of training and work-hours and research and production efficiency and waste and stupidity and greed? That hasn’t changed except to have one more layer of government bureaucracy added — because government bureaucracy always helps us so very much.

The good thing is that a lot of people who couldn’t afford insurance before now have it — and don’t get me wrong; come to cases, that’s a very good thing. The bad thing is, a lot of those people still can’t afford to buy it. Why? Because nobody is trying to address the cost.

What fixes the problem?   Same as any similar problem, what we need here is an educated public working together toward a reasonable system of providing healthcare. Appealing to our outrage? That’s no way to get an educated public.

But they do appeal to our outrage, and more so every voting cycle.  And we buy into it; we lap it right up and go out and get pissed at each other because nobody’s fixing our problems without even for a moment considering that, since they’re our problems in the first place, we ought to be the ones fixing them.  But no; we’d rather go blame someone.

Happy blinkered stupidity, American media consumer.

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4 comments

    1. It’s tough to argue with that statement, Mr. Bellamy.

      But the thing is, the EpiPen is a very minor symptom. It’s just one that we can all relate to.

      Like

  1. Hey, call me Chris. An interesting thing about EpiPens is suddenly they have a limited shelf life and have to be replaced every year. If memory serves, they are now $150 a dose, and we have to receive an annual n-service from a professional so that we are all up to date on how to administer the shot.

    Like

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