Who jacked up the price of EpiPen? Did Heather Bresch increase EpiPen prices?

Heather Bresch, the former president and CEO of the pharmaceutical company Mylan, worked directly with the CEO of Pfizer Ian Read to keep the prices of the company’s EpiPen product high, according to documents released in 2021 as part of an antitrust suit in federal court.

Bresch led an embittered defense against allegations that she was directly liable for inflating the cost of epinephrine, testifying before Congress in 2016 to defend her role in the price hikes.

However, the documents released reveal Bresch approving a scheme to force customers, captured by the company’s monopoly, to purchase two EpiPens instantly, regardless of medical need. The EpiPen is an auto-injectable device that injects epinephrine into the body.

Among the documents is an email sent on behalf of Heather Bresch, the daughter of Senator Joe Manchin, to her counterpart at Pfizer, then-CEO Ian Read. In the email, sent in January 2011, Bresch confirms a previous discussion with Read in which she stated that the two agreed that as part of a deal, Pfizer would disinvest from its EpiPen competitor, Adrenaclick. Eliminating its main competitor would subsequently allow Mylan to continue raising its prices.

In 2007, when Mylan acquired rights to market the drug from Merck (by buying its specialty pharmaceuticals subsidiary Dey), a two-pack cost less than $100, a tiny fraction of what it costs today. The result of the deal with Merck was that Mylan manufactured part of the EpiPen delivery system, but not the medication itself, while owning the brand name and the right to distribute the whole product. The drug itself was produced by King Pharmaceuticals, which manufactured it solely for Mylan.

In 2010, King announced it would be purchased by Pfizer, which was licensed to sell Adrenaclick, an EpiPen competitor, the previous year. The deal between Pfizer and Mylan led the former to withdraw its competitor from the market and partner with Mylan on Epipen, locking down a monopoly. Following the deal with Pfizer, Mylan raised the price above $600 within five years.

In June 2021, Judge Daniel Crabtree issued a summary judgment partly siding with Mylan and partially siding with the plaintiffs, implying the case goes on.

In March 2022, a Kansas judge granted preliminary approval to a settlement in which the drug manufacturer Viatris, formerly known as Mylan, agreed to pay $264 million for antitrust violations of the marketing and sales of epinephrine, the lifesaving medication it uses to make EpiPens. With a final hearing set for July, the deal puts Heather Bresch, Manchin’s daughter and Mylan’s former CEO, Read on track to dodge legal repercussions from a years-long saga involving allegations of racketeering, price fixing, and the anti-competitive sale of EpiPens.