Mylan takes on punching-bag role again as Clinton aims to shame 'bad actors'

Hillary Clinton is now taking a different tack against pharma. In a speech planned for Monday, Clinton will call out EpiPen maker Mylan as a “bad actor” for its huge price hikes, and propose new government measures to encourage competition and break monopoly access to markets.

The Mylan reference is just one of several in Clinton’s speech, and the drugmaker is the only pharma to be criticized by name, according to campaign sources cited by the Wall Street Journal.

It's unclear whether Clinton's shaming of Mylan as a "bad corporate actor" will come along with any new proposals targeted directly at pharma, rather than more general antitrust and accountability measures. But zeroing in on Mylan’s price increases--and suggesting a government push for action--adds to Clinton’s drumbeat of drug-pricing proposals that could crimp the pharma industry’s activities. If enacted, that is, which is a big If, analysts continue to believe.

A campaign official told the WSJ that the presidential candidate will Monday “condemn an in-it-for-yourself approach that celebrates the abuse of workers and consumers as ‘good business.’” 

During the EpiPen controversy that’s been unfolding since August, Mylan has defended its price increases as necessary to fund R&D, awareness campaigns and lobbying to increase access to the lifesaving emergency anaphylaxis treatment. It has blamed pharmacy benefits managers for pushing big rebates onto the company, encouraging price increases in the process--a banner that other drugmakers, and at least one congressman, have taken up. Rep. Earl "Buddy" Carter, a Republican from Georgia and the only pharmacist in Congress, penned a column for The Hill last week calling PBMs "the man behind the curtain" in drug pricing.

Attempting to share the public criticism with PBMs and other payers may help pharma shed light on the opaque U.S. drug-pricing system, which Mylan CEO Heather Bresch called “broken” and others deem “byzantine”--and certainly qualifies as unnecessarily complicated.

Meanwhile, however, Clinton continues to tout her proposals for addressing drug prices. Monday’s strike at Mylan will come along with proposals for fostering competition in the marketplace. In the pharma world, that would include Clinton’s previous proposal to streamline approval of biosimilar and generic meds--and could extend further, depending upon the specifics of the proposals she’ll unveil in Monday’s speech.

In a commentary in the New England Journal of Medicine last week, the former secretary of state reiterated her desire to force drugmakers to justify their prices and to allow Medicare to use its buying power to directly negotiate better prices for meds. In a proposal aimed at speeding generics to market, she suggests eliminating “pay for delay” patent settlements--something the Federal Trade Commission has been trying to do for years.

She also repeated her most recent suggestion--creating a “response team” to monitor the market for “excessive price spikes” on long-standing, lifesaving treatments, and penalize the companies involved.

Clinton's latest drug-pricing talk follows a Kaiser Family Foundation survey released last week showing that 77% of Americans think drug prices are unreasonable. The same survey also found "widespread support" for measures aimed at holding down prices, including Medicare price negotiation and reimportation of meds sold more cheaply in Canada. Respondents also supported requiring drugmakers to release information about how they set their prices and creating an independent board to oversee pricing, KFF said.

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