MICHEL MARTIN, HOST:
You probably heard news this week about the rising cost of EpiPens. Those are devices people carry around to inject themselves with medicine to treat severe allergic reactions. The cost has risen from about $100 for a pack of two to about $600 - all that since 2009. Now, for many people, these are not optional. These are literally lifesavers. For some, like Jill Negro, a 38-year-old mother of two children who both have severe allergies, the price hike is causing financial strain and fear.
JILL NEGRO: Lately, with the most recent increase, it's to the point that I honestly don't know how we're going to be able to continue to pay for them. You know, we make enough to pay our bills, and, honestly, it's a matter of life and death for my children.
MARTIN: The price hike has now drawn the attention of lawmakers from both political parties, who are demanding answers from the maker of EpiPens, Mylan, about what's behind the price hike. But we thought we'd ask NPR health correspondent Alison Kodjak about this. Welcome. Thanks for joining us.
ALISON KODJAK, BYLINE: Thanks for having me.
MARTIN: So is there any one factor behind the price hike? It's my understanding that the medicine itself, epinephrine, is actually quite cheap, and the technology itself doesn't seem to have changed so what's behind this?
KODJAK: You know, there's not one particular force other than that the company wants to raise the price. And, as a lot of people have told me, it's kind of what the market will bear. There isn't a good competitor, so Mylan can keep raising the price. And people are still going to buy these.
MARTIN: As this has gotten more public attention, and, as we said, lawmakers have gotten interested in this question, what's the company's response been?
KODJAK: They haven't actually given an explanation as much as a response. And that response was we're going to offer coupons to people whose insurance doesn't fully cover these - up to $300 - in order to defray their costs, which is good, but it doesn't actually reduce the overall cost in the market. So people are still, either through their insurance or some other way, spending a lot of money on these injectors.
MARTIN: You know, in the course of reporting this, we reached out to people who use EpiPens often, you know, parents and teachers, for example, to see how this is affecting them. Let me play another clip from that reporting. This is Lexi Henegar. She's a mother of six, and two of her children have severe food allergies, and this was her question.
LEXI HENEGAR: Why are they considering a coupon rather than just cutting the price and making the price more reasonable, something that everyone can afford?
MARTIN: I guess the larger question would be who decides what the cost is?
KODJAK: Well, they decide what the cost is. And the reason they would go with the coupon, as opposed to overall cutting the price, is because the insurance companies will still have to pay the higher price for those people that they cover, who aren't complaining, because they only have a $25 co-pay.
The only sort of regulation of the price is the negotiations between the insurer and the drug company. And the insurance companies certainly aren't paying the full $600. We're not quite sure how much they pay, but they're paying a lot because this is the only game in town.
MARTIN: Why now?
KODJAK: Well, you know, there's - it seems to be that people in the pharmaceutical industry have sort of caught on to the idea that they can raise prices and turn their companies into cash cows. This is not the only drug where they've looked around, realized there's no competition, and said, look, if we charge a little more, people'll still have to pay for it.
MARTIN: Before I let you go, I was wondering if there's any international comparison that we could make here. I mean, pharmaceuticals are a worldwide industry. And I just wondered, is the United States unique in allowing the cost of medication to be so free-flowing?
KODJAK: The United States is very unusual. In most advanced economies, the government has at least some, if not the role in paying for pharmaceuticals and is allowed to bargain for them as either set prices or negotiate prices. The U.S., the government is also the major payer. Medicare pays for about 29 to 35 percent, depending on how you count it, of the prescription drugs out there. But the program is barred by law from negotiating prices.
MARTIN: That's Alison Kodjak. She's a health correspondent on NPR's science desk. Alison, thanks so much for coming in.
KODJAK: Thanks so much for having me.
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