The maker of EpiPens offered patients more help to pay for its costly emergency allergy shots but didn't budge Thursday on the $608 price.
The announcement from Mylan N.V. triggered a new round of condemnation from politicians and consumer groups, who accuse the company of price-gouging on a potentially life-saving treatment.
Critics stressed that insurers, employers and taxpayers will still foot most of the cost for EpiPens. Over time, that drives up insurance premiums and the country's burgeoning health care tab.
"Everybody suffers, except the Mylan investors," said Sabrina Corlette of Georgetown University's Health Policy Institute.
This week, Mylan joined other drugmakers such as Valeant Pharmaceuticals International Inc. and Turing Pharmaceuticals, who've been blasted for mammoth price increases.
Mylan CEO Heather Bresch defended her company's price hikes Thursday, telling CNBC that lowering the price was not an option. Bresch said the company only receives $274 of the $608 for a twin-package of EpiPens. She said insurers, pharmacies, prescription benefit managers and distributors divvy up the rest.
Instead of a price cut, Mylan said it was expanding programs that help people pay for EpiPens or give them out free. It doubled the limit for eligibility for its patient assistance program, so a family of four making up to $97,200 would pay nothing out of pocket. It also said it will offer $300 copay cards, up from the current $100 per-prescription savings. That would cut the bill in half for patients who have to pay full price.
People will eventually be able to order the injected medicine directly from the company, to lower their cost.
"This step seems like a PR fix more than a real remedy, masking an exorbitant and callous price hike," Sen. Richard Blumenthal, D-Connecticut, said in a statement.
EpiPens, which have little competition, are used in emergencies to treat severe allergies to insect bites and foods like nuts and eggs that can lead to anaphylactic shock. People usually keep a number of EpiPens handy at home, school or work. The syringes, prefilled with the hormone epinephrine, expire after a year.
How much an individual pays depends on insurance coverage. Private insurers often negotiate discounts off the list price, and patient out-of-pocket costs vary by plan. Customers of Express Scripts Holding Co., the nation's largest prescription benefits manager, pay $73.50. Mylan has said that many people get EpiPens with no out-of-pocket cost.
The list price for a pair of EpiPens has been raised repeatedly from $93.88 in 2007, when Mylan acquired the product, according to Elsevier Clinical Solutions' database of prices set by manufacturers.
Numerous members of Congress and other politicians this week have called for congressional hearings on Mylan's pricing, an investigation by the Federal Trade Commission and action by the Food and Drug Administration to increase competition by speeding up approvals of any rival products.
After one EpiPen competitor was pulled from the market last year, only one rival product is available, Adrenaclick, which carries a list price of $461. But EpiPen, introduced in 1987, is so well known that most doctors prescribe it without considering an alternative.
At least two companies are trying to get U.S. approval to sell a rival brand or generic version of EpiPen. None is likely to hit the U.S. market until well into next year.
Relief could come sooner from Imprimis Pharmaceuticals, a compounding pharmacy that prepares medicines to fill individual prescriptions. It said it might be able to sell a version in a few months and would likely charge around $100 for two injectors.
Meanwhile, actress Sarah Jessica Parker, whose son has severe nut allergies, wrote on Instagram that she's cut ties with Mylan and is "disappointed, saddened and deeply concerned" over EpiPen's price. Parker was paid to participate in a Mylan campaign.
Several congressional committees have held hearings since last fall on price hikes by Valeant, Turing and a handful of other drugmakers, but prices for many drugs remain high. Unlike other countries, the U.S. doesn't regulate medicine prices, so drugmakers can charge as much as they want.
Sen. Claire McCaskill, D-Missouri, said in a statement Thursday, "I'm tired of playing whack-a-mole with these pharmaceutical companies that are grabbing obscene profits while they have a monopoly."
Now many members of Congress from both parties, along with Democratic presidential candidate Hillary Clinton, are demanding answers from Mylan.
Sen. Joe Manchin, D-W. Va. — Mylan head Heather Bresch's father, wasn't so harsh.
"I look forward to reviewing (Mylan's) response in detail and working with my colleagues and all interested parties to lower the price of prescription drugs," he said in a statement.
Carolyn Janis, 35, of Middlefield, Connecticut, is waiting to fill a new EpiPen prescription for her 2-year-old son, Noah, that's needed before he starts daycare next month. He's allergic to eggs and all nuts.
She paid $175 under an old insurance plan but now has a high-deductible plan and she's already exhausted her health savings account. Janis said she'd explore the patient assistance Mylan is offering.
"I am anxious about how much it's going to cost," she said.