Epipens have more than quintupled in price since 2004

Epipens – self-injection sticks carried by people with deadly allergies, which have to be replaced twice a year – were developed by NASA at taxpayer expense, were patented by a government scientist who receives no royalties, require no marketing, and have gone from as little as $60 each to up to $606 in a few short years (during which time the company has switched to selling them exclusively in two-packs).

Mylan, who makes Epipens, and Pfizer, who markets them in the USA, have raised the prices monotonically since the middle of the last decade. Now, they’re so expensive that many public ambulance services have stopped packing them, parents are sending their kids out with expired Epipens, and many are opting for the much-less-effective strategy of carrying a syringe full of epinephrine, and hoping they’ll be able to inject themselves if they go into anaphylactic shock (one doctor who advises this compares having an Epipen to driving a Cadillac, something that not everyone can do. Other people drive to Canada, where Epipens are $94 for non-Canadians who pay a premium because they don’t have insurance-backed prescriptions.

Mylan and Pfizer have no explanation for their pricing, apart from saying that it “reflect[s] the multiple, important product features and the value the product provides.”
This week in healthcare news

Betting that money is more persuasive than words, more employers vow to use financial rewards and penalties to prod their workers to fitness in 2012. Employers have seen serious problems related to obesity, she said, including higher rates of depression, absenteeism, low productivity and more medical claims. An overweight employee costs employers $5,000 more a year in health costs than a healthy-weight individual. The survey of 335 employers found that the share of companies that used financial rewards in health management programs increased to 54% in 2011 from 36% in 2009. In 2012, about 80% of companies plan to offer financial rewards.

What to Do About Disloyal Corporations

Just like that, Pfizer has decided it’s no longer American. It plans to link up with Ireland’s Allergan and move its corporate headquarters from New York to Ireland.

That way it will pay less tax. Ireland’s tax rate is less than half that of United States. Ian Read, Pfizer’s chief executive, told the Wall Street Journal the higher tax rate in the United States caused Pfizer to compete “with one hand tied behind our back.”

Read said he’d tried to lobby Congress to reduce the corporate tax rate (now 35 percent) but failed, so Pfizer is leaving.

Such corporate desertions from the United States (technically called “tax inversions”) will cost the rest of us taxpayers some $19.5 billion over the next decade, estimates Congress’s joint committee on taxation.

Which is fueling demands from Republicans to lower the corporate tax rate.

Donald Trump wants it to be 15 percent.

Mike Huckabee and Ted Cruz want to eliminate the corporate tax altogether. (Why this would save the Treasury more money than further corporate tax inversions is unclear.)

Rather than lower corporate tax rates, an easier fix would be to take away the benefits of corporate citizenship from any company that deserts America.

One big benefit is the U.S. patent system that grants companies like Pfizer longer patent protection and easier ways to extend it than most other advanced economies.

In 2013, Pfizer raked in nearly $4 billion on sales of the Prevnar 13 vaccine, which prevents diseases caused by pneumococcal bacteria, from ear infections to pneumonia – for which Pfizer is the only manufacturer.

Other countries wouldn’t allow their patent systems to justify such huge charges.  

Neither should we – especially when Pfizer stops being an American company.

The U.S. government also protects the assets of American corporations all over the world.

In the early 2000s, after a Chinese company replicated Pfizer’s formula for Viagra, the U.S. Trade Representative put China on a “priority watch list” and charged China with “inadequate enforcement” against such piracy.

Soon thereafter the Chinese backed down. Now China is one of Pfizer’s major sources of revenue.

But when Pfizer is no longer American, the United States should stop protecting its foreign assets.

Nor should Pfizer reap the benefits when the United States goes to bat for American corporations in trade deals.

In the Pacific Partnership and the upcoming deal with the European Union, the interests of American pharmaceutical companies like Pfizer – gaining more patent protection abroad, limiting foreign release of drug data, and preventing other governments controlling drug prices – have been central points of contention.

And Pfizer has been one of the biggest beneficiaries. From now on, it shouldn’t be.

U.S. pharmaceutical companies rake in about $12 billion a year because Medicare isn’t allowed to use its huge bargaining power to get lower drug prices.

But a non-American company like Pfizer shouldn’t get any of this windfall. From now on, Medicare should squeeze every penny it can out of Pfizer.

American drug companies also get a free ride off of basic research done by the National Institutes of Health.

Last year the NIH began a collaboration with Pfizer’s Centers for Therapeutic Innovation  – subsidizing Pfizer’s appropriation of early scientific discoveries for new medications.

In the future, Pfizer shouldn’t qualify for this subsidy, either.

Finally, non-American corporations face restrictions on what they can donate to U.S. candidates for public office, and how they can lobby the U.S. government.

Yet Pfizer has been among America’s biggest campaign donors and lobbyists.

In 2014, it ponied up $2,217,066 to candidates (by contrast, its major competitor Johnson & Johnson spent $755,000). And Pfizer spent $9,493,000 on lobbyists.

So far in the 2016 election cycle, it’s been one of the top ten corporate donors.

Pfizer’s political generosity has paid off – preventing Congress from attaching a prescription drug benefit to Medicare, or from making it easier for generics to enter the market, or from using Medicare’s bargaining power to reduce drug prices.

And the company has donated hundreds of thousands of dollars to the candidacies of state attorneys general in order to get favorable settlements in cases brought against it.

But by deserting America, Pfizer relinquishes its right to influence American politics.

If Pfizer or any other American corporation wants to leave America to avoid U.S. taxes, that’s their business.

But they should no longer get any of the benefits of American citizenship – because they’ve stopped paying for them.

As doctors who have seen too many children die of pneumonia, struggling to breathe, we are asking anyone who cares about children’s lives to join our public call on Pfizer and GSK to make sure all developing countries can afford to protect all their babies against this killer disease.
—  Dr. Greg Elder, Director of MSF Operations in Paris. Sign the petition at 

Robert Grillo:

If she can’t stay pregnant, what will she do” reads the headline in this ad for this bovine pharmaceutical product from Pfizer.

Animal agriculture is a male-dominated industry where female animals are literally and metaphorically powerless, bred and exploited for the very traits that render them servile and submissive to men. They are forcibly impregnated, repeatedly. They toil through pregnancies and give birth only to have their offspring taken from them. Their offspring are trafficked and slaughtered for flesh products. Their reward for all of their free hard labor as mothers? Betrayal. Used until “spent” and then violently killed.

Here’s a fun twist I will believe in until I am convinced it isn’t true: creepy neon murder lichen is the (undiscovered) only cure for frontotemporal dementia! Gets rid of nasty fox infestations AND reverses neurological damage!

Next season’s villain: the pharmaceutical company trying to get all members of the McCall pack to sign nondisclosure agreements about their knowledge of the special plant and its properties. They are pretty aggressive about it. Sometimes their rep interrupts while everyone is sitting in the big corner booth at the local diner, sipping on milkshakes. “Go AWAY,” Scott says to Mr. Sampson, who frowns and closes his briefcase. Isaac rolls his eyes and eats some onion rings. Lydia feeds Allison a bite of her patty melt. Kira rolls a gumball across the table at Derek, who smiles sleepily from his spot curled up under Stiles’s arm. “I’m a medical miracle,” Stiles mumbles around his curly fries. Every episode features the pack doing normal, pleasant things, with one semi-irritating interruption from Mr. Sampson. He bugs them at mini-golf. He annoys them when they’re playing cribbage at the local coffee shop. He spies on them while they sit on a picnic blanket in the park, eating finger sandwiches and giving each other hand massages.

“Is Mr. Sampson seriously watching us through the eyeholes he cut in a newspaper?” Scott asks, lifting his head from Kira’s lap.

“I’m worried about that guy,” Allison admits, pressing her thumbs into the palm of Derek’s left hand while Isaac braids her hair. “Maybe we should send him a fruit basket.”


Why Corporate Deserters Should Be Disowned 

Apple is only the latest big global American corporation to use foreign tax shelters to avoiding paying its fair share of U.S. taxes. It’s just another form of corporate desertion.

Corporations are deserting America by hiding their profits abroad or even shifting their corporate headquarters to another nation because they want lower taxes abroad. And some politicians say the only way to stop these desertions is to reduce corporate tax rates in the U.S. so they won’t leave.

Wrong. If we start trying to match lower corporate tax rates around the world, there’s no end to it.

Instead, the President should use his executive power to end the financial incentives that encourage this type of corporate desertion. President Obama has already begun, but there is much left that could be done.

In addition, corporation that desert America by sheltering a large portion of their profits abroad or moving their headquarters to another country should no longer be entitled to the advantages of being American.

1. They shouldn’t be allowed to influence the U.S. government. They shouldn’t be allowed to contribute to U.S. political campaigns, or lobby Congress, or participate in U.S. government agency rule-making proceedings. And they no longer have the right to sue foreign companies in U.S. courts for acts committed outside the United States.

2. They shouldn’t be entitled to generous government contracts. “Buy American” provisions of the law should be applied to them.

3. Their assets around the world shouldn’t any longer be protected by the U.S. government. If their factories and equipment are expropriated somewhere around the world, they shouldn’t expect the United States to negotiate or threaten sanctions, or use our armed forces to protect their investments. And if their intellectual property – patents, trademarks, trade names, copyrights – are disregarded, that’s their problem too. Don’t expect any help from us.

In fact, their interests should be of no concern to the U.S. government – in trade negotiations, climate negotiations, international treaties reconciling American law with the laws of other countries, or international disputes over access to resources.

They don’t get to be represented by the U.S. government because they’re no longer American.

It’s simple logic. If corporations want to desert America in order to pay less in taxes, that’s their business. But they should no longer have the benefits that come with being American.
#AskPharma to give all kids A Fair Shot against pneumonia.
Doctors Without Borders needs you to #AskPharma to lower the price of the pneumonia vaccine to $5/child for all developing countries and humanitarian organizations.

$17 Million: Amount Pfizer makes PER DAY on its pneumonia vaccine. It’s World Pneumonia Day, and we paid a little visit to Pfizer Headquarters…with suitcases full of fake cash. 

Despite the essential protection the pneumococcal conjugate vaccine provides, three out of four children globally still don’t get all the shots of the vaccine they need to save their lives. The price of the vaccine is too high, and many governments in developing countries simply can’t afford to buy it for their children. Join us in asking Pfizer and GSK to put children’s lives over more blockbuster revenue, by lowering the price to $5 a child:
Weekly healthcare news

Three leading senators are inquiring into drugmaker Pfizer Inc’s efforts to limit the sale of generic versions of its Lipitor cholesterol drug, which lost U.S. patent protection this week. Their concern was prompted by a newspaper report earlier this month that Pfizer had struck deals with leading insurers and pharmacy benefits managers, who negotiate prices on behalf of companies and insurers, to offer discounts on Lipitor if they block prescriptions for its generic versions

Pfizer Looking for Billions in Tax Inversion Benefits With AstraZeneca Merger

Pfizer Inc. (NYSE:PFE) has a tax inversion pill that will pump huge benefits out of the $106 billion mega-merger it is angling for with AstraZeneca PLC (LSE: AZN).

The company’s executives have publicly talked up the potential benefits of the merger, including more than $1 billion in tax savings per year.

As things stand now, AstraZeneca has once again refused the sweetened $106 billion offer made by Pfizer. But if they were to accept it, Pfizer would then be able to shift its corporate headquarters from New York City to Europe.

It’s a nice twofer that gives Pfizer the advantage of the enhanced European reach while at the same time giving it a readymade tax inversion strategy to hightail it out of Uncle Sam’s tax reach.

Pfizer, one of the world’s largest pharmaceutical companies, has been headquartered in NYC since it was founded in 1849 in Brooklyn.

A relocation of the company’s headquarters to Europe would result in the loss of billions of dollars in local, state and federal tax revenues.

Not to mention the loss of jobs and other spending that would follow the company’s headquarters across the Atlantic.

Note that an inversion doesn’t necessarily mean the company would move its operational headquarters. That would still be in NYC, but the official headquarters would be in Europe.

This would allow the company to bring in vast cash hoards that are currently being kept outside the U.S. in order to avoid the hefty tax bill it would attract. Pfizer currently keeps more than 70 percent of its cash reserves out of the U.S. to avoid being taxed on it as income.

In a conference call with investors, Pfizer CFO Frank D'Amelio said that if the holding company which would be the parent of Pfizer and AstraZeneca was located in the U.K., it would lower the company’s effective tax rate going forward.

Pfizer currently pays an effective tax rate of27.4 percent, while AstraZeneca’s effective tax rate is much lower at 21.3 percent. It is estimated that a single percentage point drop in Pfizer’s effective tax rate would mean annual tax savings of up to $200 million.

The U.K. additionally offers more tax benefits, including R&D tax credits and a lower tax rate on income from patents.   

Be that as it may, any move by Pfizer to retain operational headquarters in NYC while avoiding paying corporate income tax would be seen by lawmakers and the powers-that-be in Albany and Washington D.C. as anotherinversion tax law fail. It would make federal approval for the merger more difficult, if not impossible.

Photo credit - Norbert Nagel/wikipedia 

The Rigging of the American Market

Much of the national debate about widening inequality focuses on whether and how much to tax the rich and redistribute their income downward.

But this debate ignores the upward redistributions going on every day, from the rest of us to the rich. These redistributions are hidden inside the market.

The only way to stop them is to prevent big corporations and Wall Street banks from rigging the market.

For example, Americans pay more for pharmaceuticals than do the citizens of any other developed nation.

That’s partly because it’s perfectly legal in the U.S. (but not in most other nations) for the makers of branded drugs to pay the makers of generic drugs to delay introducing cheaper unbranded equivalents, after patents on the brands have expired.

This costs you and me an estimated $3.5 billion a year – a hidden upward redistribution of our incomes to Pfizer, Merck, and other big proprietary drug companies, their executives, and major shareholders.  

We also pay more for Internet service than do the inhabitants of any other developed nation.

The average cable bill in the United States rose 5 percent in 2012 (the latest year available), nearly triple the rate of inflation.

Why? Because 80 percent of us have no choice of Internet service provider, which allows them to charge us more.

Internet service here costs 3 and-a-half times more than it does in France, for example, where the typical customer can choose between 7 providers.  

And U.S. cable companies are intent on keeping their monopoly.

It’s another hidden upward distribution – from us to Comcast, Verizon, or another giant cable company, its executives and major shareholders.

Likewise, the interest we pay on home mortgages or college loans is higher than it would be if the big banks that now dominate the financial industry had to work harder to get our business.

As recently as 2000, America’s five largest banks held 25 percent of all U.S. banking assets. Now they hold 44 percent – which gives them a lock on many such loans.

If we can’t repay, forget using bankruptcy. Donald Trump can go bankrupt four times and walk away from his debts, but the bankruptcy code doesn’t allow homeowners or graduates to reorganize unmanageable debts.

So beleaguered homeowners and graduates don’t have any bargaining leverage with creditors – exactly what the financial industry wants.  

The net result: another hidden upward redistribution – this one, from us to the big banks, their executives, and major shareholders.

Some of these upward redistributions seem to defy gravity. Why have average domestic airfares risen 2.5% over the past, and are now at their the highest level since the government began tracking them in 1995 – while fuel prices, the largest single cost for the airlines, have plummeted?

Because America went from nine major carriers ten years ago to just four now. Many airports are now served by one or two.

This makes it easy for airlines to coordinate their fares and keep them high – resulting in another upward redistribution.

Why have food prices been rising faster than inflation, while crop prices are now at a six-year low?

Because the giant corporations that process food have the power to raise prices. Four food companies control 82 percent of beef packing, 85 percent of soybean processing, 63 percent of pork packing, and 53 percent of chicken processing. 

Result: A redistribution from average consumers to Big Agriculture.

Finally, why do you suppose health insurance is costing us more, and co-payments and deductibles are rising?

One reason is big insurers are consolidating into giants with the power to raise prices. They say these combinations make their companies more efficient, but they really just give them power to charge more.

Health insurers are hiking rates 20 to 40 percent next year, and their stock values are skyrocketing (the Standard & Poor’s 500 Managed Health Care Index recently hit its highest level in more than twenty years.)

Add it up – the extra money we’re paying for pharmaceuticals, Internet communications, home mortgages, student loans, airline tickets, food, and health insurance – and you get a hefty portion of the average family’s budget.

Democrats and Republicans spend endless time battling over how much to tax the rich and then redistribute the money downward.

But if we didn’t have so much upward redistribution inside the market, we wouldn’t need as much downward redistribution through taxes and transfer payments.

Yet as long as the big corporations, Wall Street banks, their top executives and wealthy shareholders have the political power to do so, they’ll keep redistributing much of the nation’s income upward to themselves.

Which is why the rest of us must gain political power to stop the collusion, bust up the monopolies, and put an end to the rigging of the American market.


Have you seen it? Catch our vaccine bus ad outside the #Pfizer building in NYC. Take a pic of yourself with it using the hashtag #AskPharma- Let’s call on Pfizer and GSK to lower the price of pneumonia vaccines to $5.00 per child for all developing countries. 

Nearly 1 million children worldwide die each year due to pneumonia. Pfizer & GSK have made a total of $26 billion in sales off the pneumonia vaccine. It now costs 68x more to fully immunize a child now than it did in 2001. It’s time to give all kids A Fair Shot.
Iron catalysts can modify amino acids, peptides to create new drug candidates
"This allows us to take one amino acid structure and convert it into many different structures that represent different functionalities, which could ultimately lead to different biological and physical properties of the peptide," White said. "It also expands the pool of unnatural chiral amino acids that are available to researchers to make new structures."

For medicinal chemists, making tweaks to peptide structures is key to developing new drug candidates. Now, researchers have demonstrated that two iron-containing small-molecule catalysts can help turn certain types of amino acids – the building blocks of peptides and proteins – into an array of potential new forms, even when part of a larger peptide, while preserving a crucial aspect of their chemistry: chirality, or “handedness.”

Led by Illinois chemistry professor M. Christina White, researchers from the University of Illinois at Urbana-Champaign in collaboration with researchers at Pfizer Global Research and Development detailed the new reactivity of the catalysts in the journal Nature.

“This allows us to take one amino acid structure and convert it into many different structures that represent different functionalities, which could ultimately lead to different biological and physical properties of the peptide,” White said. “It also expands the pool of unnatural chiral amino acids that are available to researchers to make new structures.”

A main advantage to the catalysts, which oxidize bonds between carbon and hydrogen, is that they preserve the amino acid’s sense of chirality. Chiral molecules can have more than one spatial arrangement of their atoms, or stereochemistry, sometimes known as “right-hand” and “left-hand” versions. Although they share the same chemical formula, molecules of opposite handedness can behave very differently in the body. For example, L-DOPA is a drug used to treat Parkinson’s disease, whereas its mirror version, D-DOPA, is biologically inactive.

“That’s why having things with defined stereochemistry can be very important for drug discovery,” White said. “It can be that a molecule of one handedness has fantastic physiological properties, but the same molecule with the opposite handedness could have very detrimental properties.”

Using the two iron catalysts, the researchers were able to take four chiral amino acids - proline, leucine, valine and norvaline – and diversify them into 21 different amino acid structures while preserving their handedness. The new structures can be used to create modified versions of existing peptides or to build entirely new structures.

Such oxidative amino acid modification is performed routinely in nature to make a variety of different peptides with different properties. Twenty common amino acids exist in nature, but are altered by carbon-hydrogen oxidation reactions to change their shape or add functional groups such as alcohols or carboxylic acids. These reactions are typically catalyzed by iron-containing enzymes. However, the enzymes are very difficult to work with in a laboratory setting, White said.

“These enzymes are also very specific. They are usually tailored to one amino acid or one peptide structure,” White said. “Two big advantages to the small-molecule catalysts we’ve developed are that they are very general – they can work on many different amino acid and peptide structures – and they are very easy to use. They can create great diversity initiated by one simple carbon-hydrogen oxidation reaction.”

Another major advantage the catalysts have is that, while they are general in what substrate they can oxidize, they are very specific about which carbon-hydrogen bonds they cut – so much so that they target a certain spot on amino acids like proline, leucine or valine even when they are part of a much larger peptide chain. For example, the researchers used the catalysts to transform a single proline-containing peptide chain into eight different peptides containing unnatural amino acids.

This is powerful because right now, if you want to make those eight different peptides, you would have to do eight different syntheses,” White said. “And before you could do that, you’d have to synthesize the individual unnatural amino acid components. With our method, you can build one peptide out of bulk chemicals and use one carbon-hydrogen oxidation reaction, coupled with a reaction to add a functional group, to produce eight new peptides all with retained handedness.”

One of the small-molecule iron catalysts, iron PDP, is available commercially from Sigma-Aldrich and Strem, and the researchers are in talks to make the second catalyst available as well.

White’s group is working on catalysts that can modify a wider range of amino acids, particularly those with electron-rich aromatic functionality, which compete with the carbon-hydrogen bonds for oxidation using the current catalyst.