3 ms·

I do think that there was some bribery and game-riggery involved with the EpiPen. The Intercept had an article enumerating the various laws that the company had

I do think that there was some bribery and game-riggery involved with the EpiPen. The Intercept had an article enumerating the various laws that the company had lobbied for or even had a hand in writing, almost all concentrated on either minimizing other manufacturers or encouraging the purchase of more EpiPens. The interesting bits are in the second half of the piece. https://theintercept.com/2016/08/24/epipen-uproar-highlights-companys-family-ties-to-congress/ https://theintercept.com/2016/08/24/epipen-uproar-highlights...

rayiner 10y ago
Nothing in that article says anything about bribery. Nothing says Mylan made any campaign contributions to anyone to keep competing products from being approved. It gives three examples: 1) Lobbying to not let Medicare negotiate with drug manufacturers. Which is a perfectly reasonable policy to avoid a creating a monosopny buyer of drugs. 2) Lobbying for the Generic Drug User Fee Act. That law imposed fees on the industry to beef up FDA resources for reviewing applications of generics. It also imposed testing requirements on foreign production facilities equal to the testing requirements imposed on domestic facilities. Again, seems reasonable, and the Act was supported by public interest organizations. 3) Lobbying for federal funding to be used to purchase EpiPens for schools. Somewhat shady, but how does that kill anybody?
- cmiles74 10y ago
  I agree that it doesn't specifically enumerate instances of bribery. It does, however, show Mylan engaged in the same sort of self-serving behavior that could, in my opinion, endanger lives. I also agree that the case of Mylan is not as dramatic as that of the Russian heart stent company.
  - rayiner 10y ago
    Whats the basis of that opinion in concrete terms, because I don't see it from the handwaving in the article.
- soundwave106 10y ago
  Actually I think point #1 reduces competition and encourages monosopnies, at least under our current situation where there are only a few major insurers. B2B market competition is probably even more important for prescription drugs than consumer market competition given the nature of medicine. That law effectively eliminates the government from engaging in competitive market practices (in other words, this gives pharmaceuticals a very large source of funds from a major purchaser of pharmaceuticals whose hands are effectively tied when it comes to both price and choice). IMHO this probably has done a lot to increase the price of prescriptions over the years. If private insurance was a highly competitive market, perhaps things would be different, but it's not. The problem with #2 is that it creates artificial scarcity. In this case, there is plenty of justification as you don't want shady medicine on the market. The question is whether the FDA is being overcautious with generics and imports. As of now there's certainly plenty of people illegally importing prescription medicine from offshore pharmacies in an unregulated manner, because prescription prices are so inflated compared to most countries. Lobbying does not produce some of the outright corruption that bribery does, but I've seen more than my fair share of lobbying encouraged laws in the US over the years where a subtext of the law was to eliminate competition. I'm not sure how much of current drug law is pharmaceutical industry influence (my gut feel is some but not all) but some of it definitely, for good reasons or not, blocks up the "invisible hand" of competitive forces. At least the good thing about a system like the US (vs. the Russian example) is that there's some hope that public outrage over the most egregious examples (your Martin Shkrelis and whatnot) will cause some changes.

rayiner 10y ago

Nothing in that article says anything about bribery. Nothing says Mylan made any campaign contributions to anyone to keep competing products from being approved. It gives three examples: 1) Lobbying to not let Medicare negotiate with drug manufacturers. Which is a perfectly reasonable policy to avoid a creating a monosopny buyer of drugs. 2) Lobbying for the Generic Drug User Fee Act. That law imposed fees on the industry to beef up FDA resources for reviewing applications of generics. It also imposed testing requirements on foreign production facilities equal to the testing requirements imposed on domestic facilities. Again, seems reasonable, and the Act was supported by public interest organizations. 3) Lobbying for federal funding to be used to purchase EpiPens for schools. Somewhat shady, but how does that kill anybody?

cmiles74 10y ago
I agree that it doesn't specifically enumerate instances of bribery. It does, however, show Mylan engaged in the same sort of self-serving behavior that could, in my opinion, endanger lives. I also agree that the case of Mylan is not as dramatic as that of the Russian heart stent company.
- rayiner 10y ago
  Whats the basis of that opinion in concrete terms, because I don't see it from the handwaving in the article.
soundwave106 10y ago
Actually I think point #1 reduces competition and encourages monosopnies, at least under our current situation where there are only a few major insurers. B2B market competition is probably even more important for prescription drugs than consumer market competition given the nature of medicine. That law effectively eliminates the government from engaging in competitive market practices (in other words, this gives pharmaceuticals a very large source of funds from a major purchaser of pharmaceuticals whose hands are effectively tied when it comes to both price and choice). IMHO this probably has done a lot to increase the price of prescriptions over the years. If private insurance was a highly competitive market, perhaps things would be different, but it's not. The problem with #2 is that it creates artificial scarcity. In this case, there is plenty of justification as you don't want shady medicine on the market. The question is whether the FDA is being overcautious with generics and imports. As of now there's certainly plenty of people illegally importing prescription medicine from offshore pharmacies in an unregulated manner, because prescription prices are so inflated compared to most countries. Lobbying does not produce some of the outright corruption that bribery does, but I've seen more than my fair share of lobbying encouraged laws in the US over the years where a subtext of the law was to eliminate competition. I'm not sure how much of current drug law is pharmaceutical industry influence (my gut feel is some but not all) but some of it definitely, for good reasons or not, blocks up the "invisible hand" of competitive forces. At least the good thing about a system like the US (vs. the Russian example) is that there's some hope that public outrage over the most egregious examples (your Martin Shkrelis and whatnot) will cause some changes.