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In a rare appearance since the EpiPen controversy flared this summer, Mylan Pharmaceuticals CEO Heather Bresch accepted “full responsibility” Thursday for the price hikes that caused national outrage.

“If EpiPen had to be the catalyst to show what hardworking families are facing, it will have been worth it,” she said at the Forbes Healthcare Summit in New York, referring to the upfront costs that many people encounter with high-deductible health plans. Mylan increased the price of an EpiPen two-pack nearly 550 percent to $608 over the past decade.

But, Bresch reiterated remarks she made about the price of EpiPen at a congressional hearing in September, citing a lack of transparency in the pharmaceutical pricing system for the controversy surrounding the product. She justified the price increases by pointing to what she insisted were “investments” made to improve the device and patient access.


“We invested more than $1 billion to create access and awareness and improve the product,” she said during the industry conference. “There’s a lot of misinformation out there, but we now reach 80 percent more patients than when we acquired EpiPen,” about a decade ago. “The idea that there was no advancement in the product was inaccurate.”

Bresch argued the company redesigned the emergency allergy device so that patients would not stick themselves with the needle. And as part of the effort, Mylan broadened patient access by working to make the device available to schools across the country, which included donating about 700,000 EpiPens. “Over the years, we balanced that innovation by building awareness,” she said.


However, Bresch did not offer a breakdown of the billion-dollar investment she cited, such as the extent to which those dollars may have included the cost of its lobbying campaign to win wider access to school districts. It’s also unclear whether the $1 billion also covered regulatory fees or marketing expenses associated with widening the EpiPen franchise.

To bolster her statement on transparency, she said, “The current system was not built on the idea of consumer engagement … but it’s where health care needs to move. There are unintended consequences when the patient goes to the pharmacy counter and doesn’t know what the price will be … transparency would improve this.”

These are essentially the same arguments that Bresch has made for months after criticism of EpPen pricing transformed Mylan into the latest poster child for pharmaceutical greed.

Since then, the company has made plans to sell its own authorized generic version of EpiPen at roughly half the price. And Mylan said it agreed to a $465 million settlement with the Department of Justice for shortchanging Medicaid over rebates, although several lawmakers criticized the deal. Federal authorities have never actually confirmed the deal happened.

Meanwhile, the Federal Trade Commission was asked by various lawmakers to investigate whether Mylan violated antitrust laws because the contract for one option in the discounted school program, at one time, contained a clause forbidding school districts to buy rival products. The FTC has only said it is aware of these concerns.

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