As you may have heard, the cost of a life-saving EpiPen from drug maker Mylan increased as much as 600% in just nine years, causing lawmakers and health advocates to call on the drug company — and its CEO Heather Bresch — to lower the cost and provide answers for its increase in the first place. But that could be difficult given the executive’s personal connections not only to the medication, but one legislator. 

Heather Bresch, who has served as CEO for Mylan for nearly four years, is the daughter of West Virginia Senator Joe Manchin. She’s also, apparently, played an integral part in EpiPen’s rise to the top of both the drug market and price sheets, Stat News reports, noting that at one point she referred to the drug as “her baby.”

Under her tenure, the auto-injector went from a seldom-used product to one of the few available urgent treatment options for allergy sufferers facing anaphylaxis.

That popularity, which was crafted through advertising, price hikes, and federal incentives, resulted in a pen that contains about a $1 dose of the drug epinephrine somehow costing nearly 400-times more on the wholesale market.

While there are a whole lot of unknowns surrounding the skyrocketing price of EpiPens, it’s clear that the increase is tied to Bresch’s work and her rise within Mylan.

Here are six things you should know about Bresch, her role at Mylan, her connections to Congress, and the rising cost of EpiPens.

1. A LONG TENURE

Bresch has worked for Mylan for most of her adult life. She’s climbed the corporate ladder, as it is, from secretary to chief operating officer, and eventually to CEO in 2012.

2. A DIAMOND IN THE ROUGH

In 2007, Mylan paid $6 billion to acquire Merck’s generic drug division. That deal included the EpiPen technology, which at the time was bringing in around $200 million a year.

According to Stat News, Bresch saw more revenue potential in the product and took EpiPen on as a pet project, intent on creating a top-seller out of the brand.

3. TROUBLED WATERS

However, things got off to a rough start. Soon after being appointed as COO, Bresch faced her own scandal. An investigation by the Pittsburgh Post-Gazette found that she hadn’t actually graduated with an MBA from West Virginia University.

Instead, a report found that her transcripts had been falsified, in part, by officials for the University. While Bresch came out of the ordeal relatively unscathed and with her job intact, several of those administrators resigned.

4. LOOKING FOR ASSISTANCE

After the acquisition of Merck’s brands was finalized, Bresch and Mylan set out to expand the availability and use of the EpiPen.

To do so, she led a lobbying effort to spread the work about the risks of anaphylaxis and how the device could save lives — especially in schools.

Bloomberg estimates the lobbying campaigns cost about $4 million between 2012 and 2013. The funds went toward lobbying for the medication in general and for legislation that would put the drug in schools. The company became the top corporate sponsor of the Food Allergy Research & Education group that pushed a bill that would entice schools to keep EpiPen injectors on hand.

These efforts were spearheaded, in part, by Bresch, who had previously served as Mylan’s government relations director.

5. GETTING THE ASSISTANCE

In 2013, a big break came when Congress adopted the School Access to Emergency Epinephrine Act, providing financial incentives for states to enact their own laws requiring schools to keep non-student specific epinephrine auto-injectors on hand in case of an emergency. This, of course, benefited Mylan because EpiPens are the largest — and nearly only — option for this kind of drug.

Under another program, Mylan agreed to provide four free EpiPens to schools each year. After that, schools have to pay for the additional medication, Bloomberg reports.

Stat News reports that each year after the Act was adopted Mylan increased the price for EpiPens.

It’s unclear just how much the price of these pens increased each year, but the cash price for an EpiPen has increased somewhere between 400% and 600% in the last decade. Today, a pack of two pens can cost hundreds of dollars at retail.

6. THE SENATOR’S DAUGHTER

While lawmakers are demanding that Mylan reduce the cost of the EpiPen medication immediately and provide answers for why the company increased the cost in the first place, few have actually placed the blame on Bresch.

Stat News suggests that could be because of Bresch’s close ties, given her father’s status as a senator.

Connecticut Senator Richard Blumenthal in a letter Monday asked the pharmaceutical giant to lower the cost, but shied away from talking about Bresch’s involvement a day later, Bloomberg reports.

Still, Bloomberg reports that the House Oversight and Government Reform Committee has scheduled a meeting with Mylan. No details of that meeting have been disclosed.

The EpiPen was her ‘baby.’ Now this pharma CEO is in the hot seat over price hikes [Stat News]
The Senator’s Daughter Who Raised Prices on the EpiPen [Bloomberg]

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