EpiPen & Narcan: Less Death = More Profit, Contrary To What You've Been Told
Written By: Anton Sawyer
It never ceases to amaze me when you look at the numbers of those who claim to be "pro-life" that seem to think that this “life” they spent so much time giving rights to before birth, doesn’t matter once they are out of the womb. In all fairness though, they profess to be pro-life, not “pro-quality-of-life.” The number of people who know they have a mental illness and simply cannot afford to get the help they need is astonishing. The laws being changed in a plethora of states to remove aid from poorer children/families to get even the most basic of needs like food and wellness—both mental and physical—completely flies in the face of “all lives matter.” Though the reason most often given is either “how are we going to pay for this?” Or something along the lines of “people need to be responsible for themselves and their family. If you cannot afford to have children, then you shouldn’t have them. Practice abstinence.” I’m going to tackle those responses by looking at the United States healthcare system. I will keep the arguments within the framework that health and money co-mingle, but show that not everything being professed by our congressional leaders is congruent with the realities of life.
In an attempt to maintain complete transparency, all research and statistical fact-checking for this article, and all articles, can be found at our site's bibliography linked here.
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One of the biggest national healthcare debates online is why people are being charged so much for EpiPens, but Narcan costs very little—yet both save thousands of lives annually.
For those who don't know, I'll give a brief overview about these two medicines.
EpiPen is a “device that administers a dose of epinephrine, used for the emergency treatment of an acute allergic reaction.” If you have a severe allergy or know someone who does, then you have probably seen one as they typically are not far away from the person in question. My ex-wife had a niece with a peanut allergy. Any time there was a family event where food was consumed, her EpiPen was always close by. Everyone knew of the allergy and to not use peanuts in their dishes, but the EpiPen was literally the only barrier between life and death.
If you don’t know what Narcan is … you are incredibly lucky. Narcan is the brand name of the drug Naloxone, and it is used in the event that someone has overdosed on opioids. It’s either injected or, most commonly, administered via nasal spray. When comparing the price difference between these two, there is a valid argument to be found.
Time Magazine researched the cost for Naloxone in 2018 and found that, sadly, because of the deaths attributed to the opioid epidemic, the prices of this life-saving substance had dropped in many areas. They found that the price of Narcan can vary greatly depending on your insurance plan and the type you want to buy. Overall they broke down the medians and found that generic Naloxone can cost between $20 and $40 per dose, while Narcan can cost around $130 to $140 for a kit that includes two doses. They also found that many local public health organizations or community groups dedicated to treating drug addiction offer naloxone free of charge. Some programs provide discounts for some brands of the medication, and if your insurance covers Naloxone, the co-pay at your local pharmacy could be as low as $0. With EpiPens, it’s a much different story.
Because the price increases that occurred between 2007 and 2017 were so high (being 500%, or $600-plus for a two-pack branded EpiPen), it caused a huge public outcry. This has helped prices come down over the last few years. Consumer Reports did a study in 2017 about the price increase and insurance company response. They found that at the time, if you had commercial insurance, a $25 coupon could lower your copay to zero, depending on your insurance coverage. These coupons, however, wouldn’t work for anyone trying to use them in conjunction with Medicare, Medicaid, or other federal or state insurance. They found that those without insurance could get some discounts. Some lowered the price for the two-pack generic EpiPen to around $200 at Walgreens or RiteAid. So yes, when comparing them at face value, there is a huge difference in the fact that one has a price tag and the other is easier to get and more feasible is something to look at. This also plays into the question from earlier that opponents love to use, the cost. When you look at the numbers, it’s surprising the cost of the EpiPen in comparison to Narcan. Forbes magazine did a complete breakdown of the value of the EpiPen in 2016. The way it was broken down was pretty succinct. The methodology was explained as such; “to discuss ‘value-based pricing’ of pharmaceuticals, we need to determine if a drug’s price is greater or less than its ‘value’–which means we need to convert both to the same units, dollars. So, let’s take a rudimentary stab at calculating the health economic value of an EpiPen. Using math breakdown, you have to consider it as an ‘insurance’ value. You could consider its ‘value’ as the product of the odds of the bad outcome it could prevent and the cost of the bad outcome. To make a simple analogy: if I think the odds of a fire in my house are 1% per year, and that a fire would cost me $500,000 in damages, then I might be willing to spend 1% x $500,000 = $5,000 annually on fire extinguishers, smoke detectors, and fire insurance to prevent my home from burning down.” To see the complete math breakdown, you can click the link in our Bibliography. After it was all said and done, “to get to the value per patient per year–in other words, what we should be willing to pay annually for an EpiPen–we need to divide the total value by the number of customers. Thus, using a reported estimate of 15 million U.S. patients (6 million kids and 9 million adults) diagnosed with food allergies, this analysis yields an annual value of an EpiPen to each of these diagnosed patients of $120.” This is an estimated annual yield, and each life saved by the EpiPen would yield 59 additional life-years—or 46,020 life-years for the estimated 780 fatalities that would be caused without the medical aid. In all reality, the cost isn’t that much different between the two. And though we know that we are in the middle of a raging opioid epidemic, it would be foolish to look at the numbers and say that the need for EpiPens is much less than those in need of Narcan. Per Food Allergy Research and Education, each year in the US, 200,000 people require emergency medical care for allergic reactions to food.
Even taking these numbers and setting them aside, there are also two sure-fire ways to ensure a financial windfall for the healthcare community; tragedy or expansion/availability. Though I’ve written about the monetary benefits that are seen by the wealthy when it comes to tragedy in the wake of the Covid-19 pandemic (you can read about that here Why Are The Wealthy Profiting From Human Suffering?), there is also a personal experience I can draw from to help illustrate this point. Between 2008 and 2014—right before I started working in the music industry as a journalist—I worked for a diagnostic laboratory associated with a major university. I was able to tender my resignation once I got my first professional writing gig, but for those six years prior, I got to immerse myself in the world of healthcare as a processing technician. My job was to data-entry information from the hospital the sample came from, and then make sure the lab technician had all of the details to run the correct test at the correct time. Because we worked with dozens of labs, I came into contact with any and every kind of body part you can imagine. Blood, plasma, tissues, urine samples for drug testing, etc. I’m not going to get too much more specific, but let me just tell you I have seen kidney stones the size of a golf ball … and it only goes downhill from there. I started right before the Great Recession hit. The company had just done massive hiring, and I was one of the last to be in my training class before they put a freeze on it. We had staffed up correctly per the prior years’ expectations. Given the company had already been around for about 30 years before I started, they had a good idea of what to expect based on years prior, but when the recession hit, they immediately lifted the hiring freeze because they were blindsided. We were expected to work on at least one of our days off, and overtime before or after regularly scheduled shift hours was also highly encouraged. Because of this, even new people such as myself were averaging almost $20 per hour with 50 hours a week. The general public was scared to death that they were no longer going to have insurance, and so they wanted to get all testing done while they still could. It was fear. People who may have felt a lump were running to get it checked out. Anyone and everyone who could see a doctor was. It eventually leveled out in 2010 and we slowed down to normal.
Shortly after our workload lightened, former President Obama signed The Affordable Care Act (ACA) into law. It took some time to reach everyone that it was intended for, but when it did during 2012, it was another financial windfall for the healthcare industry. Millions who were never able to see a physician was now able to. We were just as busy after the ACA went fully into effect as we were when the Great Recession hit, if not more so. Again we had to participate in mandatory overtime, and since I had been there for a few years, I was making a little over $24 per hour at 50 hours a week. My paychecks at that time had been higher than any other company I had worked for in my adult life. Because of the huge gains the company had made, it all trickled down to every employee on every level. To be honest, it was the first time I ever saw trickle-down economics actually work. Bonuses were given to all employees; it was truly a time of riches. And this is the point; you can still make huge financial gains as a company in the healthcare industry, even if it’s from a government-assisted program.
It’s like in the film Monster’s Inc. when they realized that a child’s laughter was a more potent energy supply than their screams. I know, trying to compare a serious issue with a Disney film seems to downplay the seriousness of the subject, but in this case, it makes sense. If you give more people access to healthcare, even if it’s under a capitalistic system, you are going to reap massive financial benefits. The bottom line isn’t going to be drastically undercut. The amount of money lost in cost-per-visit will be more than made up for in volume. So whenever I hear a governmental leader talk about how financially crippling it is to the healthcare industry when you lower costs and increase availability, it rings so hollow. It simply isn’t true.
Money aside, I did want to end by discussing the philosophy of healthcare as a right—the second argument about personal responsibility I wrote about in the first paragraph. Because I have witnessed both Narcan and EpiPens administered to different people, I personally believe that these two items should be available en masse at no cost. They do save lives. If we’re lead to believe that we are a nation of Christians—which I feel is HIGHLY debatable—and one of the pillars to that faith is being your brother’s keeper, then having these drugs available should be a no-brainer. The thought of any life being taken, whether by accident or intent, should be avoided at all costs. Of course, what I think and feel has nothing to do with reality. We live in a country where healthcare is a business, not a right. Even then, when you look at the ability the healthcare industry has to modify the costs as needed when met with certain types of plights like the opioid epidemic, you have to ask where the difference truly is?
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