EpiPens, Mylan’s Ethics Inversion, and the U.S. Government Smoking Gun

Mylan Pharmaceuticals deserves the attention it is getting.  Heather Bresch, Mylan’s CEO has every reason in the world to have the smug press photos.  After all, she’s used the mortality of millions who suffer from sudden and acute allergic reactions and heart problems to line her own pockets and those of her investors (while squirreling cash outside the U.S. for tax evasion-like purposes).  Together with Wendy Cameron (Cam Land LLC and Trustee at The Washington Hospital from 2009-2011), The Honorable (retired judge) Robert J. Cindrich (Cindrich Consulting), Robert J. Coury, JoEllen Lyons Dillon (the Chief Legal Officer for the 3-D printing ExOne Company), Neil Dimick (retired EVP at AmerisourceBergen), Melina Higgins (former partner of Goldman Sachs), Douglas J. Leech (Founding Principal of DLJ Advisors), Rajiv Malik, Dr. Joseph C. Maroon (Neurosurgeon at University of Pittsburgh Medical Center), Mark W. Parrish (CEO of Trident USA Health Services), Rodney L. Piatt (Horizon Properties Group LLC), and Randall L. Vanderveen, PhD, R.Ph. (University of Southern California’s School of Pharmacy) – Mylan’s esteemed board of real estate developers, bankers, lawyers, medical educators, and corporate executives – her leadership has steered the company into the maelstrom of public controversy around the insanely expensive EpiPen®.  Forbes reported that Bresch’s compensation rose 671% in 8 years.  For this reason, Forbes and others should be doing their stories on the people I listed above – the board of directors of Mylan who were willing to endorse a business strategy as ethical as arms dealers in Lord of War. 

Let’s cut to the chase.  Bresch is at best guilty of hyperbole and at worst lying when she was quoted on CNBC saying that, “No one’s more frustrated than me.  My frustration is, the list price is $608.”  In 2011, the same product sold for $164.  In 2007, it was available for $57.  Does she really want the public to believe that she’s frustrated that the Food & Drug Administration has been propping up her company’s monopoly on a technology and drug that’s been in the public domain since the 1950’s.  Does she love to know that her firm is pocketing $1 billion for a technology that was acquired from Merck in 2007?  Does the public know that the FDA and Congress have willfully succumbed to the pressure of corporate America by ignoring their own rights to the technology! 

Let’s take a little journey down memory lane so that Iowa Senator Chuck Grassley, Presidential Candidate Hillary Clinton and Mylan’s contemplable board can get on the same page!  When George Calkins and Stanley Sarnoff invented the EpiPen forbearer in 1973, they acknowledged that their ideas were improvements upon work commissioned for the U.S. and U.K. military emergency medicine needs in the 1960s!  That the U.S. Patent Office granted their patent in 1973 was, at the time, a bit of a stretch as it was more about a mechanical design improvement – not a real invention.  This technology, used in the military and in EMS kits around the world was the basis for their company.  As the U.S. Government was a principal buyer of anaphylaxis injector pens and funded a considerable amount of the technical improvements thereto, the U.S. government has march-in rights to use the technology at a reasonable commercial royalty rate it can set!  The U.S. Governments EpiPens don’t cost $608 per unit.  Meridian Medical Technologies – the Department of Defense’s supplier of the actual EpiPen (owned by Pfizer) – have the ability to deliver the exact same product at a price between $40 - $70.  And let’s face it, Congress knows about this.  The FDA knows this.  And the reason why Mylan gets away with this – just like they get away with incorporating out of the U.S. using the dubious inversion strategy for tax efficiency – is because powers that be love to provide liquidity to their benefactors!

The U.S. Patent Office and the U.S. Food and Drug Administration have given Mylan license to rob the public based on a set of accommodations which are clearly illegal.  Pfizer’s Meridian Medical is cruising along under the radar with a very clear statement on their website stating that their technology is “Available only for use by United States military personnel.”  And Sarah Jessica Parker is keeping the Hollywood face on the whole racket unaware that what she’s encouraging parents and school districts to do is really to enrich a dubious corporation while preying on real public fear. 

Cut the crap.  This is another example of media hype around a faux well-spring of public activism around price gouging.  But let’s get real.  If we don’t want our kids to die from a bee-sting or a peanut, we should demand accountability where it’s really due – the Patent Office that granted an illegal monopoly, the FDA which props up the illusion, and a board of directors at Mylan who don’t take the time to inform themselves of their own company’s misdeeds. 

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Out of Time

When the DeLorean vanishes into tire tracks of flames in the 1985 classic Back to the Future, the California license plate left spinning on the pavement is emblazoned with “OUTATIME”.  Having accelerated to 39.3395 meters per second (88 mph) the entire car was able to exploit the 0.10717 second wormhole opened by the lightning strike to blast into the future without becoming the victim of a relativity Cuisinart.  Why time travel involves extreme cryodynamics (the car reconstitutes covered with ice) is something I’ll save for another blog as dynamic temporal translocation could be more logically considered an isothermal reality devoid of friction or other exothermic physics.  On this 8^th of August (88), I’d like to take the TIME to examine and refute the illusion of TIME.

Humans have reportedly observed movements of stars, the sun and the moon and have used these as indicators of auspiciousness.  Carvings in stone, slits that allow the passage of lights during equinox and solstice moments, orientations of rocks and buildings, geometric projections of precession of events, all suggest some awareness of “time” in the human narrative.  Comically, the concept of one second (which for those of you burning to know, is “the duration of 9,192,631,770 periods of the radiation corresponding to the transition between to hyperfine levels of the ground state of the caesium 133 atom”) and the notion of linear measure – the meter (also based on caesium 133) – are but two of Einstein’s legacies which have given us the illusion of the linear progression of time. 

For several weeks, I’ve encountered innumerable conversations, interactions, and high order social frictions triggering nearly incapacitating pain derived entirely from the illusion of time.  Dreams of a future, legacies of a past, the vindication of hours of training for the moment of Olympic glory, the futility of living based on aging, nostalgia, optimism, pessimism – all of these bandits robbing humanity of its authentic experience in favor of the elixir of “the other”.  Benedict De Spinoza’s Ethics courageously challenged the illusion of time when he stated that, “By substance I understand what is in itself and is conceived through itself, that is, that whose concept does not require the concept of another thing, from which it must be formed.”  He also states that, “In nature there is nothing contingent,” suggesting that the only thing that exists simply exists.  Centuries later, one of my favorite philosophers, Karl Popper expanded on these notions when examining the concept of human temporal and causal obsessions.  He argued that there is no possibility of apprehending all of the conditions which manifest the present and, as such, neither an explanation of the “past” nor a prognostication of a “future” is viable in any way.  “Individual human action or reaction can never be predicted with certainty, therefore neither can the future.” (The Poverty of Historicism). 

In the past several years, the economy (and society) has suffered the fatal effects of its implicit addiction to temporal illusions.  Debauched on the addiction to time as a linear, progressive construct we insist that ontological and algebraic ‘laws’ dictate explanation and prediction.  Manipulate supply and demand, manipulate interest rates or relative employment, manipulate wage and price ratios and magically you have a managed economy.  Only it doesn’t work out that way.  Resource providers impoverished by predatory extractors rise up in revolt shutting down the mine and the mill – at times killing the operators or the opposition faction.  Central banks pump fractional currency into economies only to watch asset values bloat while real monetary flows constrict.  Progressive Regressionists (those who explain causality through their own myopic observational reductionism) are convinced of model adequacy based on post hoc rationalization only to find that none of their models hold in the next moment.  “We value most what we measure best,” becomes an aspirational justification for experts to peddle worthless advice to public policymakers bent on placating the masses long enough to feed their egotistical ideals of incumbent power. 

As I celebrated an auspicious night at the Sydney Opera House listening to the Australian Youth Orchestra’s breathtaking rendition of Gustav Mahler’s Titan Symphony No. 1 in D I was absorbed with the contours of the genius of the third movement.  The complexity of rhythms weaves a tapestry punctuated with the staccato of the cuckoo birds call (played on clarinet) and to decipher the meter of the piece is to the rational mind as elusive as the most complex metaphysical construct is to the nascent philosopher.  In fact, what makes the piece so beautiful is not its meter but its movement.  And while physics will tell you that motion is a change in position with respect to time, this definition is constrained by artifice.  The acoustical feast that Mahler serves suspends time and was described by him in its modified score as the depiction of, “a Spring without end… the awakening of nature in the early morning.” 

A Spring without end.  Idigna.  The Mesopotamian ideal of an artesian water source that ever springs and flows ceaselessly.  Inanna’s dance of fertility which acknowledged the persistent, generative, infinite interaction between lovers, land, and life.  The effortless recognition that gratitude-filled moments of recognition of the mystery that is the persistence of life and love gain nothing from a “past” and offer nothing to a “future”.  In fact, what they do is heighten the emotional and observational intelligence in each moment to more perfectly perceive the ever present, always in flux, phase of NOW.  Has your life ever improved by justifying or rationalizing a “past”?  Have you ever lost a moment of Present based on your obsession with a yet unlived and unmanifest “future”?  If the answer to either of these is yes, stop.  Recognize that if you’re reading this, you’ve made it to here, now.  Be grateful.  Now think about all that you steward – your life, your love, your resources, your encouragement, your touch, your generosity – and find a person with whom to share it.  Don’t look for them.  Don’t wait.  Act NOW.  And in the acting of every now in its perfection, recognize that the only pain you feel is your choice to hold onto time.  Step out of time and step into unconstrained living.  You may be surprised that it doesn’t hurt and you just might heal.

BTW, I’ve included two articles from the 1987 Electronics Today which will demonstrate that the more we think that time is a linear function, the more we willfully ignore our own evidence to the contrary.  Think about China trade, the French DCNS contract to the Australian Navy, and the recent expansion of the F-35 program,  and ask yourself if anything has changed?

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