EpiPen price hikes may be causing outrage, but those pale in comparison to the huge increases that Mylan Laboratories took on dozens of other medicines earlier this year.

For instance, the company raised the price of ursodiol, a generic medicine used to treat gallstones, by 542 percent. There was also a 400 percent boost in the price for dicyclomine, which combats irritable bowel syndrome, and a 312 percent increase for metoclopramide, a generic drug that treats gastroesophageal reflux disease.

Those eye-popping increases were actually first disclosed two months ago by Wells Fargo analyst David Maris, amid a national debate over prescription drug prices. The disclosure put Mylan on the defensive because, until then, the company had avoided the harsh spotlight fixed mostly on Valeant Pharmaceuticals and Turing Pharmaceuticals, which was run by Martin Shkreli.


The Mylan price hikes also underscored that big increases are not always confined to brand-name drugs. Mylan, you may recall, is one of the world’s largest purveyors of copycat medicines. Two years ago, in fact, prices for some generic drugs rose substantially — one topped 17,000 percent — and generated congressional interest. At the time, Senator Bernie Sanders (D-Vt.)  and US Representative Elijah Cummings, (D-Md.) held hearings into big price moves made by 14 drug makers.

The lawmakers seized upon the price hikes because generics are traditionally seen as low-cost alternatives to more expensive brand-name drugs. This explains why generics now account for nearly 89 percent of all prescriptions written in the United States, according to the IMS Institute for Health Informatics, the market research firm.

Their effort petered out, though, partly because prices did not rise for most generic drugs. At one point last year, in fact, price increases for generics largely paused, according to Sector Sovereign Research, which tracks the pharmaceutical market. In effect, price hikes for generics were largely eclipsed by events elsewhere in the broader market for prescription drugs.

Until the Wells Fargo report, Mylan may also have escaped scrutiny because some of its drugs may not cost huge amounts even with large percentage price increases. For example, the cost to purchase 120 tablets of metoclopramide is about $10, according to GoodRx. A huge jump in percentage terms is less likely to have an impact than for a drug that already costs hundreds of dollars.

Natalia Bronshtein/STAT Source: Wells Fargo

Then there’s ursodiol. There are several other companies that sell the generic drug for combating gallstones, although the Mylan list price of $495 for a bottle of 100 pills is fairly similar to four other copycat versions, according to Truven Health Analytics. This suggests the company raised its price to be in line with the other manufacturers and so may also explain why the price hike did not generate much notice otherwise.

EpiPen stands out from the rest of the Mylan portfolio, however. This is largely because it is a lifesaving medicine for people of all ages who experience allergic reactions. But the device is widely relied upon by parents, and the notion that the cost of the drug might mean children are denied treatment is the sort of image that only fans negative perceptions of the pharmaceutical industry.

In any event, the price hikes can help the bottom line. One Mylan drug, known as Tolterodine Tartrate ER, which is used to treat overactive bladder, generated nearly $191 million in sales last year, according to Wells Fargo’s Maris, who cited IMS data. Between January and June this year, Mylan raised the price by 56 percent. Such a price hike can generate a substantial boost to revenue.


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  • In my opinion actual increases in retail prices are more telling. One example is a Mylan product, first patented in 2006, of a transdermal skin patch containing selegiline (EMSAM) used to treat major depressive disorder, Parkinson’s disease, and other nervous system conditions. This patent for Emsam currently expires in 2018. This is the earliest possible date that a generic version of Emsam could become available. However, there are other circumstances that could come up to extend the exclusivity period of Emsam beyond 2018. These circumstances could include things such as other patents for specific Emsam uses or lawsuits.

    In 2008 the retail price of EMSAM for a 30-day supply was approximately $493. In 2012 it was approximately $628. Sometime in 2015, the retail price was increased to approximately $1,600 ($53/patch)! Sure, as is the customary public relations business strategy of Mylan, a coupon is available on its website, but even at a discount of $500/month who can afford it when most of the insurance companies have moved this medication from a preferred/covered medication to a non-preferred/not covered medication?

  • Quality and Affordability of generics must go side by side with sustainability of their production on a minimum economic scale.

    • I hope their greed burns them bad. They are stealing from the general public who pays for this s*** with the outrageous unaffordable insurance premiums for their unaffordable drug prescriptions that truly cost pennies to the dollar to make. Insurance companies should not be involved in prescription drugs. It would be affordable if drug companies like this had to base their prices on what people can afford rather than hiking the price because insurance will pay any price leaving the ones on premiums with the bill plus profits.

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