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Senators seek information on EpiPen price increases’ impact on Medicare, Medicaid, Children’s health insurance programs


This news story was published on September 1, 2016.
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www.mylan.com

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WASHINGTON, DC – U.S. Senators Amy Klobuchar (D-MN), Chuck Grassley (R-IA), and Richard Blumenthal (D-CT) have called on the Centers for Medicare & Medicaid Services (CMS) to provide information on the effect of Mylan’s price increases on the government’s prescription drug costs. The alarming price increase of Mylan Pharmaceutical’s EpiPen not only harms consumers who face high out of pocket costs, it also has increased the costs to the federal government through Medicare Part D, Medicaid, and the Children’s Health Insurance Program. According to data recently released from CMS, spending on Medicare Part D drugs increased 17 percent from 2013 to 2014, despite only a three percent increase in claims. In a letter to CMS, Klobuchar, Grassley, and Blumenthal requested information to better understand the impact of the EpiPen price spike on the government’s prescription drug costs.

“We write to request information regarding how much the Centers for Medicare & Medicaid Services (CMS) is currently paying for Mylan Pharmaceutical’s EpiPen, an epinephrine auto-injector used to treat severe allergic reactions. Since acquiring the lifesaving drug in 2007, Mylan has raised the price of an EpiPen Two-Pack from $100 to approximately $600 today. This alarming price increase not only harms consumers who face high out of pocket costs, it also has increased the costs to the federal government through Medicare Part D, Medicaid and the Children’s Health Insurance Program (CHIP),” the lawmakers wrote. “Large prescription drug price increases are an urgent issue in our country that demands attention. We look forward to receiving your responses to understand how Mylan’s price increases have affected Medicare Part D, Medicaid and CHIP, and, thus, how these price increases have burdened American taxpayers.”

The full text of the lawmakers’ letter is below.

Dear Acting Administrator Slavitt:

We write to request information regarding how much the Centers for Medicare & Medicaid Services (CMS) is currently paying for Mylan Pharmaceutical’s EpiPen, an epinephrine auto-injector used to treat severe allergic reactions. Since acquiring the lifesaving drug in 2007, Mylan has raised the price of an EpiPen Two-Pack from $100 to approximately $600 today. This alarming price increase not only harms consumers who face high out of pocket costs, it also has increased the costs to the federal government through Medicare Part D, Medicaid and the Children’s Health Insurance Program (CHIP).

According to data recently released from CMS, spending on Medicare Part D drugs increased 17 percent from 2013 to 2014, despite only a three percent increase in claims. Double digit increases like this are unsustainable and place a large financial burden on the federal government, and ultimately, taxpayers. We want to better understand the impact of the EpiPen price spike on the government’s prescription drug costs. Accordingly, we request the following information:

1. Please provide on an annual basis from 2007 to the present (including partial year or estimates for the current year) for Medicare Part D, Medicaid, and the CHIP program separately:

a. The average amount CMS has paid in reimbursement for an EpiPen Two-Pack;

b. The total amount CMS has paid in reimbursement under Medicare Part D for EpiPen;

c. The average out-of-pocket costs to patients with Medicare Part D.

2. Please provide the information in request one above for Adrenaclick and Auvi-Q.

3. We are interested to know how much states are paying for EpiPens through Medicaid and CHIP. We have heard reports from states that EpiPen is considered a non-innovator multiple source drug through the Medicaid Drug Rebate Program. This means states only receive a 13 percent rebate of the Average Manufacturer Price (AMP) per unit. If EpiPens were considered an innovator multiple-source drug, states would receive the greater of 23.1 percent of AMP or the difference between AMP and the best price per unit as adjusted by the Consumer Price Index for All Urban Consumers (CPI-U). Please explain why EpiPens are considered a non-innovator multiple source drug rather than an innovator multiple source drug.

Large prescription drug price increases are an urgent issue in our country that demands attention. We look forward to receiving your responses to understand how Mylan’s price increases have affected Medicare Part D, Medicaid and CHIP, and, thus, how these price increases have burdened American taxpayers. Thank you for your attention to this important issue. Please respond by September 13, 2016.

——–

Last week, Sen. Grassley wrote to the manufacturer of the EpiPen, used for emergency treatment for life-threatening allergic reactions, to explain a steep price increase in the product in recent years. Grassley’s letter came after Iowans expressed concern to him about the prices. Grassley also led a letter from five senators to the Food and Drug Administration, seeking details on whether alternatives to the EpiPen are in the works. The EpiPen maker, Mylan, announced that it will expand patient assistance programs for the product. Today, the company announced that it will make a generic version of the product available. Grassley made the following comment.

“This sounds like good news but the details are important to know. Consumers and Medicare, Medicaid and insurance companies will want to know how widely available the generic product will be. I look forward to a written response, as specifically requested in my letter to the company, to my questions on behalf of Iowans and public health care programs about the EpiPen cost increases. I hope the response will offer details about the company’s announcements on more patient assistance and the availability of a generic product. And I continue to look for a written response from the FDA on the status of any alternatives to the EpiPen and what might have created delays in introducing those alternatives to the market.”

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