In her testimony, Bresch tried to defend her pricing of the device that delivers an antidote to potentially deadly allergic reactions.
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Bresch was on Capitol Hill on the defense before the House Oversight Committee, whose hearing was prompted by the outpouring of outrage over EpiPen prices. Bresch defended the cost. She explained that while the wholesale acquisition cost (WAC) of an Epipen two-pack is now $608, Mylan gets only $274 for each two-pack.
Bresch said that although she regretted that some patients had trouble paying for the drug, lawmakers needed to recognize that Mylan had greatly increased access to the lifesaving device.
Bresch has been back-peddling for weeks following complaints from Democratic presidential nominee Hillary Clinton, lawmakers and consumer groups about a marketing strategy that drove up the list price of the two-pack almost six-fold since 2007, from $100 to $600.
In nearly four hours of questioning, the soft-spoken CEO at times seemed unsure, or declined to answer directly, when asked questions about the company’s finances and profits, angering lawmakers.
Jason Chaffetz, a Republican from Utah, suggested a generic version would actually make more for Mylan because the company could sell it directly to customers.
The frustration was bipartisan.
Congressman Elijah Cummings of Maryland is the ranking member on the Committee on Oversight and Government Reform.
Bresch, for her part, insisted that Mylan did not gain as much profit from the EpiPen as ” many people incorrectly assume”, putting the company’s actual net profit per pen at about $50.
After costs – including giving almost 700,000 free EpiPens to schools – the company makes only $50 on each injector, she said.
Members of Congress also asked Bresch about the role of her mother, Gayle Manchin, in encouraging schools across the country to stock EpiPens. Bresch blamed the furor partly on the complexity of drug pricing. Bresch said Mylan plans to submit an application to the FDA in the next few days for a product that would have at least a 24-month shelf life, compared with the current 18 months.
“I am a very conservative and pro-business Republican, but I am sickened by what I’ve heard”, Rep. John Duncan (R., Tenn.) said.
Chaffetz says parents don’t have a choice. “After subtracting EpiPen-related costs, our profit is 100 or 50 dollars per pen”, Bresch said. But Chaffetz said he finds that “a little hard to believe”. As of now, EpiPens expire after one year. She also touted Mylan’s discounts to schools and to the uninsured and those with high deductibles. That requires investment, Bresch said.
Bresch, daughter of Sen. Joe Manchin, D-W.Va. But lawmakers so far haven’t given any deference to her, and several other committees have called for investigations into the price increase.
“Suddenly feeling the heat, Mylan has offered a generic version and cut the price in half, so that does beg the question, what was happening with that other $300?” he asked.
It said it will also keep in place a $300 savings card for the branded EpiPen and patient assistance programs.
“I would say saving the USA 180 billion dollars”, she replied, without explanation. “Price and access exist in a balance, and we believe we have struck that balance”.
“They never, ever, ever lower their prices”, he said.
A review of Mylan profits by David Maris, a pharmaceutical analyst at Wells Fargo, shows that the unit that markets EpiPen increased its operating profit margin from 8.8% in 2008 to 60.3% in 2016.
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Also on Tuesday, West Virginia Attorney General Patrick Morrisey said he was investigating the rebates and the possibility that Mylan violated the state’s antitrust law when it sued and settled with a would-be generic competitor.
