Why didn't Mylan CEO Heather Bresch back down when attacked about the company's repeated price increases on EpiPen? Two years later, Bresch is still blaming the "broken" U.S. pricing system for the huge spike in cost for the anaphylaxis rescue injection.
Speaking with CNN's Poppy Harlow, Bresch said she didn't want to "curl up in a corner," apologize and lower the price. Instead, she said she put her "effort and energy to ... talk about what needed to be fixed, and how broken the system was."
And how did Bresch feel when her own father, U.S. Sen. Joe Manchin, D-W.Va., attacked companies that avoid U.S. taxes by doing a deal to move abroad—the very thing she planned to do via an Abbott Labs product buyout?
"You're getting swept up in the headline and the emotion of it versus understanding substantively what is at hand," she told her father at the time, she said to Harlow, adding "He was lucky I was like, 10,000 miles away," when it happened.
Little did she know when the EpiPen crisis arose, but other drugmakers would rally behind that EpiPen defense, and it's still reverberating as the pricing debate continues.
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After years of hikes that sent EpiPen's sticker price up above $600 for a two-pack, Mylan's actions came to a head in 2016. The FTC kicked off an antitrust probe, and Congress hauled Bresch in for a hearing. As a response to the firestorm, the company pledged to boost its patient access program and launch an authorized generic.
Since then, other drug pricing controversies have popped up, and the Trump Administration has rolled out its plan to rein in prices. Bresch told CNN she had "optimism for this administration because I thought they were disruptive," and has met with administration officials on multiple occasions.
But, she said, "Congress is not very solution-oriented," adding that fixing an "overcomplicated" healthcare system will take a great deal of effort.
Last month, President Donald Trump and Department of Health and Human Services secretary Alex Azar unveiled the administration's pharmaceutical cost-fighting plan, with proposals to boost generic competition, pricing negotiation and more. The administration wants to end regulatory "gaming" that stifles generic competition and re-examine the system of pharmacy benefit managers negotiating discounts. Mylan could benefit from the administration's plan to boost generic competition.
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Whether all of Trump's ideas will make it into action remains to be seen. But the tax inversions Manchin criticized have gone out of fashion, thanks to new Treasury Department rules that make them less attractive.
That's more or less what Manchin called for after Mylan inked its deal to buy Abbott Labs' European generics business. But Bresch maintains that the deal was in the best interest of Mylan and West Virginia—the state Manchin represents and where Mylan is headquartered.
Bresch said her father didn't think about "what, unfortunately, West Virginia could look like without Mylan in it," she said.
Like other generic drugmakers, Mylan has faced U.S. generic pricing pressure in recent years. As a response, the company recently cut loose 500 employees in West Virginia to "right-size" what it says is one of the world's biggest pharma plants.
Mylan is also positioning its pipeline to focus on complex generics such as its copycat to GlaxoSmithKline's Advair. It's also forging ahead in biosimilars, with an approval to its version of Amgen's Neulasta expected this year.