The EpiPen scandal and perceptions of the Washington establishment
© Mylan

Over the last few days, the nation has found itself captivated by yet another scandal. This time it involves the anaphylaxis-combating EpiPen. For millions of Americans vulnerable to suffering possibly fatal asthma attacks and allergic reactions, the lifesaving epinephrine auto-injection device is an absolute necessity.

The immediate outrage centered on the clear appearance of price gouging by generic pharmaceutical firm Mylan, the manufacturer of EpiPens. In less than a decade, the price of a dual-pack of EpiPens has increased from just under $100 to over $600. The bulk of that price increase, as the New York Times reported, has come in the last three years. Further fuel was added to the fire when it was discovered that Mylan's CEO, Heather Bresch and other top Mylan executives each received salary increases of approximately 700 percent over the last eight years, as was reported by the Washington Post.


The economic side of this story was definitely enough to captivate the public, but the story only continued to evolve, entering into a significantly darker arena. As it turned out, Bresch is the daughter of Senator Joe ManchinJoe ManchinAngus King: Losing climate provisions in reconciliation bill weakens Biden's hands in Glasgow Independent senator: 'Talking filibuster' or 'alternative' an option Rep. Khanna expresses frustration about Sinema MORE of West Virginia, and with that revelation the scandal enveloped the political machine in Washington. While the familial relationship alone is enough to draw the ire of many Americans, the gravity of the situation may very well be more sinister, and is certainly more complicated.

The concerning issue revolves around perceptions of powerful politicians wielding their political influence in support of personal connections. In a short historical analysis, we know that during his time as a state senator in West Virginia, well before he entered the United States Senate in 2010, Manchin met with Mylan co-founder Milan Puskar, which resulted in Bresch securing a low-level job at the firm. In and of itself, this may not be worthy of raising an eyebrow. However, Bresch climbed the corporate ladder hopping from entry level, to chief lobbyist, President, and ultimately to becoming the company's CEO in 2012, and it's here where the proverbial rubber meets the road in this story.

According to a 2013 article featured in Barron's, in 2012 Bresch assisted lawmakers in drafting regulatory reform legislation for the pharmaceutical industry. The first piece of legislation she effectively co-authored was the Generic Drug User Fee Amendments in 2012. According to the FDA, the purpose of this program was "to speed access to safe and effective generic drugs to the public and reduce costs to the industry".

The second piece of legislation she helped craft was the School Access to Emergency Epinephrine Act of 2013. Upon signing the bill into law, the White House summarized the legislation by stating, "The law makes an important change to the Children’s Asthma Treatment Grants Program and other federal asthma programs, which authorizes the Department of Health and Human Services to give funding preferences to states for asthma-treatment grants if they: maintain an emergency supply of epinephrine (EpiPens), if they permit trained personnel of the school to administer epinephrine, and if they develop a plan for ensuring trained personnel are available to administer epinephrine during all hours of the school day."

While having emergency epinephrine in schools is a great and potentially lifesaving concept, the bill itself specifically endorsed EpiPens, which are manufactured and sold by Mylan. Furthermore, as the New York Times reported, in the three year period following the passage of the School Access to Emergency Epinephrine Act, the price of EpiPens experienced the bulk of its exponential growth, climbing from $265 to $609 per dual-pack.

The issue that's concerning here, and the issue that drives the divorce between the average American and government, is the possible exhibition of legislative favoritism. Mylan is Senator Manchin's second largest individual corporate campaign donor and its CEO is his daughter, which alone presents an uncomfortable cozy relationship between a public official and the private sector.

Add to it that Senator Manchin openly supported both of the bills his daughter co-authored, which specifically bolster Mylan's bottom line, and the appearance of undue influence becomes a little more plausible.

To make matters worse, it appears that Bresch received incredible access to lawmakers, which may well have been facilitated by her father's position in the Senate. It was reported that over the course of developing these regulatory reforms that Bresch made hundreds of visits to Capitol Hill to meet with her father's colleagues, to which Senator Manchin proudly quipped "All these senators were flabbergasted when they found out she was my daughter. Of course, John Dingell wanted to adopt her."

To many, the situation appears to be a possible glimpse of the nefarious political reality many Americans have long suspected exists and has utterly dominated this election cycle. That through uncomfortably close relationships, the well-connected act in concert with politicians to affect a mutual benefit, a benefit that may very well come at the detriment of the masses.

While this particular chain of events falls short of substantiating any sort of ironclad case of questionable dealings between Senator Manchin, his daughter, and her firm, it certainly provides grounds for an indictment in the court of public opinion.

Jesse Heitz has written and presented over a dozen research papers at both domestic and international conferences, and has written pieces on numerous topics for a variety of publications. He obtained his BA in History from the University of St. Thomas in 2010, a MA in War in the Modern World from King's College London in 2014, and was approved. 


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