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Mylan price hikes on many other drugs eclipsed EpiPen increases

The headquarters of drugmaker Mylan Laboratories Inc. in Canonsburg, Penn.
Jeff Swensen/Getty Images
The headquarters of drugmaker Mylan Laboratories Inc. in Canonsburg, Penn.

EpiPen price hikes may be causing outrage, but those pale in comparison to the huge increases that Mylan Laboratories Inc. took on dozens of other medicines earlier this year.

For instance, the company raised the price of ursodiol, a generic medicine used to treat gallstones, by 542 percent. There was also a 400 percent boost in the price for dicyclomine, which combats irritable bowel syndrome, and a 312 percent increase for metoclopramide, a generic drug that treats gastroesophageal reflux disease.

Those eye-popping increases were actually first disclosed two months ago by Wells Fargo analyst David Maris, amid a national debate over prescription drug prices. The disclosure put Mylan on the defensive because, until then, the company had avoided the harsh spotlight fixed mostly on Valeant Pharmaceuticals International Inc. and Turing Pharmaceuticals, which was run by Martin Shkreli.

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The Mylan price hikes also underscored that big increases are not always confined to brand-name drugs. Mylan is one of the world’s largest purveyors of copycat medicines. Two years ago, in fact, prices for some generic drugs rose substantially — one topped 17,000 percent — and generated congressional interest. At the time, Senator Bernie Sanders, a Vermont Democrat, and US Representative Elijah Cummings, a Maryland Democrat, held hearings into big price moves made by 14 drug makers.

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The lawmakers seized upon the price hikes because generics are traditionally seen as low-cost alternatives to more expensive brand-name drugs. This explains why generics now account for nearly 89 percent of all prescriptions written in the United States, according to the IMS Institute for Health Informatics, the market research firm.

Their effort petered out, though, partly because prices did not rise for most generic drugs. At one point last year, price increases for generics largely paused, according to Sector Sovereign Research, which tracks the pharmaceutical market. In effect, price hikes for generics were largely eclipsed by events elsewhere in the broader market for prescription drugs.

Until the Wells Fargo report, Mylan may also have escaped scrutiny because some of its drugs may not cost huge amounts despite large percentage price increases. For example, the cost to purchase 120 tablets of metoclopramide is about $10, according to GoodRx. A huge jump in percentage terms is less likely to have an impact than for a drug that already costs hundreds of dollars.

EpiPen stands out from the rest of the Mylan portfolio, however. This is largely because it is a lifesaving medicine for people of all ages who experience allergic reactions. But the device is widely relied upon by parents and the notion that the cost of the drug might mean children are denied treatment is the sort of image that only fans negative images of the pharmaceutical industry.

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In any event, the price hikes can help the bottom line. One Mylan drug, known as Tolterodine Tartrate ER, which is used to treat overactive bladder, generated nearly $191 million in sales last year, according to Wells Fargo’s Maris, who cited IMS data. Between January and June this year, Mylan raised the price by 56 percent. Such a price hike can generate a substantial boost to revenue.

Ed Silverman can be reached at ed.silverman@statnews.com. Follow Ed on Twitter @Pharmalot