The EpiPen pricing controversy is one of many events that have drawn attention to the escalating price of medical objects and procedures in the past year. Turing Pharmaceuticals’ Daraprim pricing scandal beginning in the fall of 2015 (about which I’ve written previously for Somatosphere) and Theranos’ meltdown earlier in 2016 on the news that the high-priced tests they performed were not as advertised has kept the issue of high drug prices in the public eye. In the EpiPen pricing case, many journalists and members of the food allergy community have critiqued the credentials and motives of Mylan CEO Heather Bresch. From analyses of her possibly fraudulent MBAto critiques of her compensation to her political connections via her US Senator father, her rise to corporate stardom on the strength of EpiPen revenue has been put under the microscope.
One thing that sets these scandals about the costs of medical care apart from previous debates (such as those surrounding the cost of health insurance in the wake of the Affordable Care Act) has been the attention paid to specific pharmaceutical companies and their specific pricing strategies. In each instance, the CEO of the company has been placed in the spotlight, portrayed as both the representative for the complex goings-on within their companies which generate such pricing strategies and an avatar for corporate greed in healthcare. Yet while blaming the CEO satisfies the forensic itch of reporters and congresspeople, it obscures some important structural issues at play in healthcare today. In particular, the methods now used to raise operating capital and bring new products to market have made healthcare CEOs increasingly beholden to a new set of actors with new expectations for company conduct and performance: shareholders, debt-holders, and various types of private investors.