EPI PRICES  
 

Monday, Feb. 25, 2019 ​ ​ Fraser Street Commons, 115 S Fraser Street 
5:00 TO 7:00 PM 

THE RISING DRUG COSTS AND OUR INABILITY TO PAY  

WHAT IS A DELIBERATION? 
A deliberation is a long and careful discussion regarding an issue. By exploring an issue
without creating a debate around it, we allow ourselves to consider different approaches
and weigh the options. The goal is not to reach an agreement or define a solution by the
end of the deliberation. Rather, it intends to create thought and discourse about a topic
through an analysis of the possible outcomes to its approaches. 
 
 

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ABOUT 
In the past decade, prescription drug prices have been skyrocketing. The creation of the first
complex drug has allowed pharmacies to replicate with ease. However, this is at the cost of the
consumers. Examples include insulin, epipens, and over 250 other oral medications such as
birth control. Back in 2007, a pack of two epipen injectors costed $94. Today, consumers
experience them at a price of $600. The price of insulin has doubled from 2012 to 2016 and
continues to rise today. So, why is this an issue? These drugs are highly used for medical safety
reasons. As prices continue to fluctuate, lives are being put at risk just because people cannot
afford these life necessities. It is essential that we find an optimal way to sell these drugs at a
price that is accessible to everyone that is in need.
 
APPROACHES 
 
Government Regulations 
This approach allows Medicare to negotiate with drug companies on the prices of prescription
drugs. Right now, the government approves all safe and effective drugs and lets drug
companies set their own price for them. Allowing Medicare to negotiate prices with drug
companies will most likely cause companies to lower their prices. In addition, speeding up the
FDA approval process for generic drugs will bringing cheaper drugs to market faster.

Hands Off 
A hands off approach to drug price regulation encourages new experimentation and medicinal
development. Studies have shown that prescription potency remains relatively the same and are
still usable after their labeled expiration date. Because of this, it is not necessary to buy
prescriptions such as epipens every 18 months because most prescriptions stay potent and
useful even after four years. If users kept their “expired” prescriptions, the impact of drug prices
would not be as significant to consumers.

Government Subsidies 
With government intervention, subsidizing allows the difference to be paid by the government
which lowers the costs of drugs for consumers. The implementation of subsidies for
pharmaceutical companies will lower retail expenses while enhancing the processes of research
and development. This type of coverage will reduce production cost since a significant part of
the expense is taken care of by the government.
 
FRAMEWORK FOR DELIBERATION 
The Set Up:
➔ Introduce the deliberation and topic to be discussed
➔ Explain who is affected by this issue and how it does so
➔ Carefully analyze 3 approaches that could provide as solutions to the problem
➔ Summarize the approaches and discuss both the attractive and controversial points.

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vital research and development
Approach 1   that leads to new drugs.
● Some disagree with increased
Government Regulations  government involvement in our
healthcare system
Pharmaceutical drug regulation in the US is very
➔ Speed up FDA approval of cheaper
different from most other developed countries, and
generic drugs with the same effect as
as as a result, drug prices are much higher in the
brand name drugs
US than in these other countries. Many
◆ Advantages: Generic drugs are
commentators argue that the drug price inflation
cheaper than brand names, therefore
problem can be solved, or at least lessened, by
their rapid approval will reduce
allowing Medicare to negotiate with drug
overall drug spending​5​.
companies. In addition, the FDA’s drug approval
◆ Disadvantages: To speed up FDA
process is currently very slow-moving and
approval without compromising the
significantly delays the release of low-priced,
thoroughness of its process would
generic drugs, causing buyers to spend even
require additional manpower and
more.
money.
Currently
1​ ​
➔ The US approves every drug that’s proven Food and Drug Administration - Government agency
responsible for investigating and approving drugs before they
to be safe and effective and allows drug are brought to market
2​
companies to set their own price for it. US federal health insurance program for people 65 and older
3​
Kliff, Sarah. “The True Story of America's Sky-High
◆ The FDA​1​ approval process takes Prescription Drug Prices.” ​Vox​, Vox Media, 10 May 2018,
years. 4​
​Cubanski, Juliette, and Tricia Neuman. “Searching for Savings
➔ In many other developed countries (i.e. in Medicare Drug Price Negotiations.” ​The Henry J. Kaiser
Family Foundation,​ The Henry J. Kaiser Family Foundation, 26
Australia, Canada and Britain) the Apr. 2018.
company must 5​
Sherwood, Ted. “The Generic Drug Approval Process.” U S
◆ First prove to a government agency Food and Drug Administration, Center for Drug Evaluation and 
Research, 28 Nov. 2017.
that the drug is more effective and cost
effective than whatever is currently on
the market.
◆ Then negotiate with the government
what price it will be sold at​3​.
➔ Consequently, ​drugs cost on average
three times more in the US than in
Britain.
Proposal
➔ Allow Medicare​2​ to negotiate drug prices
on behalf of its beneficiaries.
◆ Advantage:​ its leverage would likely
cause companies to lower prices​4​.
◆ Disadvantages:
● Some argue that because this
would lower pharmaceutical
revenues, it would ​stifle the
companies’ abilities to invest in

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Approach 2    ➔ Disadvantages​: Very few EpiPens may not
Hands Off Approach  
Dealing with the hands off approach, the main goal is to
show that EpiPens do not expire as quickly as their
expiration dates state, meaning that families do not need
to pay the high prices as often as they do now.
➔ It has been found that after the written expiration
date of medications, the potency still remains. So,
the fear of getting deathly sick from taking
medication after the expiration date is for the
most part, a myth.
➔ It is simply the potency that decreases, so worst case
scenario, more dosage than usual may need to be
taken to get the same effects as a usual dosage
before the expiration date.
➔ Especially in the case of EpiPens, which retain much
of their potency, ​it is better to use an expired
EpiPen than suffer the consequences without
one​3​.
◆ If people were able to keep their
EpiPens longer without them expiring,
there wouldn’t be a need to buy them
as often as people do. Even though
the cost is still expensive, there
wouldn’t be as big of a need to buy
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them every 18 months like there is
now.
◆ Most prescriptions stay just as potent
and useful even after 4 years after the
expiration date​4​.​ If people kept their
“expired” prescriptions for longer,
they would not be as impacted by
the price of the medication.
➔ Many people’s EpiPens are covered under their
insurance so they do not have to pay upwards of
$600 for their prescription.
➔ Mylan, a global pharmaceutical company, has
donated 700,000 EpiPens to schools for children​5​.
◆ This relieves the burden of having to
pay for EpiPens for a child at school.
➔ Advantages​: Since EpiPens are still safe and
potent years after their expiration dates, the
high price does not have to be paid as
often​.
work as well after expiration, meaning​ they
might not be as effective​.
3​ ​
Anderson, Leigh Anne. “Drug Expiration Dates - Are Expired
Drugs Still Safe to Take?” ​Drugs.com​, Drugs.com, 11 June
2018, ​www.drugs.com/article/drug-expiration-dates.html​.
4​
Allen, Marshall. “The Myth of Drug Expiration Dates.”
ProPublica​, ProPublica, 18 July 2017,
www.propublica.org/article/the-myth-of-drug-expiration-dates​.
5​
Silverman, Ed. “Congress Scolds Pharmaceutical Company's
Price Hike on EpiPens.” ​PBS​, Public Broadcasting Service, 23
Aug. 2016,
www.pbs.org/newshour/health/congress-scolds-pharmaceutical
-companys-price-hike-epipens​.
 
 
  

◆ They would cover some of the huge

expenditures of research and
Approach 3   development.
➔ Government subsidies can ​rapidly speed up

Government Subsidies  the process of finding cures for life

threatening diseases
Approach three covers peak government intervention
➔ By subsidizing large research companies and
with the implementation of Government subsidies for
allowing them to maintain patents, they are
pharmaceutical companies. Subsidizing includes paying
encouraged to find new cures with the promise
the pharmaceutical companies the difference in the
of a 10-12 year monopoly on the drugs they
expensive drugs so that consumers can buy more of the
create (American Bar Association)
life saving drugs for a lower cost.
Disadvantages
Currently
➔ There is an ​extreme difference in the cost​ of ➔ In America, the retail price of a drug in ​entirely
a pair of EpiPen autoinjectors due to up to the discretion of the company
◆ Subsides or not, a company may
government subsidization.
choose to maintain their prices
◆ America: 600 dollars
➔ There is a large possibility for wasteful
◆ Europe: 69 dollars (Business Insider)
spending
➔ The main economic problem with drug
◆ Subsides can be costly and if not
companies is not the actual production cost of
properly regulated can cause a net
the medication itself, ​the problem lies within
increase in taxes for the American
the money and time spent on research.
people
◆ After research to find the correct
➔ Subsidizing and funding the wrong companies
formula, the drugs typically only cost
leads to unprecedented prices and crony
dollars to produce. (CNBC).
capitalism
➔ The Health and Human Services Department
funded vaccine research for diseases such as
Ebola, Zika, and Anthrax and the cures for
these life threatening diseases were all found. 6​
Mangan, Dan. "Epipens Cost Just Several Dollars To Make. Customers
Pay More Than $600 For Them". ​CNBC​, 2019,
Proposal
https://www.cnbc.com/2016/08/25/epipens-cost-just-several-dollars-to-m
➔ Relies on the economic principle that ake-customers-pay-more-than-600-dollars-for-them.html​.
increasing outside funding will simultaneously
7​
lower production cost "Why The $600 Epipen Costs $69 In Britain". ​Crain's Chicago Business​,
2019,
➔ Subsidies lower the retail costs of these cures https://www.chicagobusiness.com/article/20160929/NEWS03/160929744
once they are created /why-the-600-epipen-costs-69-in-britain​.

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Approach  Currently  Proposal 

● The US approves all ● Let Medicare negotiate

drugs and lets drug drug prices
companies set the ● Increase government’s
Government  prices involvement in
● The US approves drugs healthcare
Regulation  differently than other ● Speed up FDA approval
developed countries process of generic drugs
● FDA approval process ● Reduce overall drug
for generic drugs takes spending
years

● New EpiPens are ● Fewer payments for new

purchased before EpiPens
replacement is needed ● Usage of insurance
● EpiPens are donated decreases the price paid
Hands Off  and covered by for new EpiPens
insurance

● The companies are ● The government will pay

allowed to act privately private companies to
and price to their desires decrease the price of life
● Epipen prices have risen saving drugs like
Government  535% from the years Epipens
2007 to 2014 without the ● Subsidies will be placed
Subsidies  government attempting on multiple different
to help citizens with the overpriced drugs across
extreme rise in prices America

 
 

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