The premise is that $57 was the old price. and they bumped it up to $318.
And a DIY group can pull it off for $30, without economy of scale.
From wikipedia "In 2007 when Mylan acquired the rights to market the product, annual sales of all epinephrine autoinjectors were about $200M and EpiPen had around 90% of the market; in 2015 the market size was around $1.5B and Mylan still had about 90% of the market"... $1.5B annually... So if FDA testing costs them $10,000,000 anually, thats still less than 1% of their revenue.
That means that with economy of scale, and dispersing the cost of testing over several million sales, they could easily produce a product for $30. But they don't because they dont really care about saving lives, they care about getting paid. They would prefer people die than them make less money.
Completely not about "hey do it this cheap easier way" but "heres the rock solid proof that a $300 (even $60) EpiPen is stupid"
As a consumer I could see this for $75 - $100 retail (and some discount to institutional buyers) but $30 is probably not viable and of course $300 is ridiculous.
If you are low volume, you're gonna have to sell at $8 - $10 to make something worthwhile.
Now, I get it, they are unquestionably overcharging for this drug and delivery system. I just don't think you can say that since I can make something at the rock bottom price of $x that someone else should be able to make a living (or run a pharma corp.) by selling at a similar price. The sweet spot is somewhere between $30 and $300, where it is is probably closer to $100.
A soda machine is basically free money because syrup and water cost pennies. The cup is the most expensive thing you give to the customer for his $1.99 soda.
Anyway, my main point was that ingredient cost is only one part of the cost of making/delivering something.
IIRC, restaurants aim for foodstuffs to amount to 30% or less of sales to be viable.
If significant competition existed, epipens would cost very close to $30 or however much they cost to make. There are many viable businesses operating at low margins.
They (including epipens) probably cost about $10 to make. That's total cost, from production to delivery to the retail outlet. They would have been handsomely profitable at the old price of $57.
They cost $35 to the NHS in the UK.
If healthcare is public service then profitability is not a primary concern. Data-driven decisions shows that approaching healthcare as a public service is much more effective.
The choice here is rather obvious, yet for some reason, average people who would benefit immensely from a public health system in the US seems to disregard it as socialist, paying for someone else and so forth.
Please note that drug corporations are insanely lucrative in Europe too, so a public health care system doesn't seem to harm drug companies all that much, financially speaking.
IMO you need to give the drug companies enough money to cover their operating expenses and R&D costs and give some margin to stay afloat. But not more than that. It's hard to do because this aspect is one that is handled well by free market - but in healthcare, you very much care about the thing free market utterly sucks at - product quality. You need regulation to ensure the product is good enough, and many of the important criteria are not immediately verifiable by the customer at the point of sale. Trying to reconcile those two issues is the hard problem.
The point is, it isn't all black and white. If a kid has a severe allergy, sure, make sure you have a real EpiPen and carry it with you always. For those borderline cases, well, something like this might be fine. Having it reduces a really small risk even more.
Another interesting point: even if a kid has a severe food allergy, they are still more likely to die from a car accident than from an allergic reaction. Some people lose perspective.
http://well.blogs.nytimes.com/2013/12/06/food-allergies-less...
The not-so-grey ethical issue is the cost of these devices, and the fact that there are people who are too poor (medicare doesn't cover them, according to the article) to get them. Until we build a system that prevents this unjust situation, it is my opinion that there is nothing questionable about this 'hack'.
That said, USG may be too beholden to Big Pharma at this point for anything to be done.
That said, it looks like this is just reusing an existing off-the-shelf autoinjector used for insulin. If it fails, you could remove the needle and inject manually. The biggest risks I see here is making sure the epinephrine stays sterile, and that the dosage is correct. (To be clear: Either of these could have serious consequences.)
Costs should cover R&D but this is outright greed and in an industry where it's literally peoples lives at stake it can't be allowed to continue.
http://www.bloomberg.com/politics/articles/2016-08-24/the-se... https://www.theguardian.com/business/2016/aug/24/epipen-ceo-...
So? Is she just not supposed to work?
You are basically saying that she needs to be kept below a glass ceiling because of who her father is.
It's still all medical grade parts isn't it?