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 The bloggers, more than a dozen mothers of children with serious
allergies, embraced the effort Mylan outlined in a series of
"summits" it held for them beginning in 2013.
They wrote impassioned posts on blogs shared with tens of thousands
of followers on social media. Their personal testimony helped
persuade a number of state lawmakers to pass bills to get schools to
stock epinephrine injectors, such as the EpiPen, according to
legislators and others familiar with the lobbying effort.
During the same period, the company was marking up its EpiPen to
more than $600 per twin pack, six times the 2007 price, creating a
burden for many of the bloggers' followers, other parents of
children whose lives are threatened by bee stings and peanuts.
At least four of the bloggers told Reuters they believe Mylan took
advantage of their goodwill. Some have joined public criticism of
those price hikes.
"I personally believe that Mylan held the summits to gain blogger
trust and then used those bloggers to spread word about their
initiatives. They raised prices while those initiatives gained
traction," Ruth LovettSmith, a former food-allergy blogger from
Massachusetts who attended three summits, said in an email.
Mylan spokeswoman Lauren Kashtan declined to comment on the
criticism.
But in an email, she said the company regretted that it had not
anticipated "the potential financial issues for the growing minority
of patients" whose EpiPens are not covered by insurance or a patient
assistance program.
Mylan now offers coupons to more families to cover out-of-pocket
costs and said it would soon release a half-price EpiPen.
Kashtan also said the blogger summits served a worthy purpose.
"Mylan aimed to provide access to information, resources and
expertise about anaphylaxis and life-threatening allergies," said
Kashtan, who represented the company at four summits. "We are proud
to have brought together such a passionate and dedicated group of
advocates."
Chief executive Heather Bresch was blasted Wednesday at a hearing
before U.S. lawmakers who, along with prosecutors in several states,
are investigating the price hikes.
EpiPen sales exceed $1 billion a year and command more than 90
percent of the market.
STEAKS AND BLOG POLISHING
The effort to get epinephrine injectors into schools is a point of
pride for Mylan, which has credited its alliances with advocates for
its success.
"We have collaborated with government officials, leading advocacy
organizations, parents, caregivers and healthcare professionals to
successfully champion legislation and policies," Mylan said in a
2015 report on its social responsibility efforts.
LovettSmith, whose son has nut allergies, went to her first Mylan
blogger summit in January 2013 at a boutique midtown Manhattan hotel
overlooking the Empire State Building.
It was the first of at least four summits, each involving about 15
bloggers, some of whom attended more than one event. They wrote
about being treated to three-course dinners featuring pan-seared
yellow fin tuna or marinated grilled hanger steak.
At a 2014 summit at the company's Canonsburg, Pa., headquarters,
Mylan brought an outside communications consultant to help the women
polish their blogs, advocate to policymakers, practice on-camera
television interviews and speak at public events, participants told
Reuters.
Homa Woodrum, a lawyer in Las Vegas whose 8-year-old daughter relies
on EpiPens for nut and oat allergies, attended that summit. But she
skipped an invitation to a May 2015 event at California's
Disneyland, uncomfortable with the shift in venue to a resort.
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"It starts to seem a little like you're being buttered up," Woodrum
said.
Bloggers who attended summits testified on behalf of schools' bills
in Nevada, Maine and Michigan, according to interviews and
legislative records. In all, 48 states adopted laws requiring or
enabling schools to stock epinephrine injectors. In many cases,
Mylan subsequently donated EpiPens to schools.
Stanley Short, a Democratic representative who co-sponsored the
Maine bill, credited a blogger with alerting him to the issue. The
woman, who attended the Disneyland summit, brought her son to a
legislative hearing, where he demonstrated how he would press an
EpiPen into his thigh to stop an allergic reaction.
Mylan's lobbyist attended the hearing, but the boy's show-and-tell
"sealed the deal," Short said. "With me and most of the legislators,
it's that first-hand experience of a mother talking about her child
and a child talking about what they go through personally that did
it."
MIXED REACTIONS
Bloggers who went to Disneyland told Reuters pricing was not on the
drugmaker's agenda. By then, some were aware of the hikes and
brought them up. Mylan talked about the role of other parties,
including insurers, in determining what consumers pay, they said.
Blogger Kelly Rudnicki's food allergy advocacy led to work as a paid
Mylan spokeswoman. But, she said in an email, she quit last month
because of the pricing controversy. She said she believes Mylan
should apologize and cut its prices on EpiPens, and Bresch should
step down.
Rudnicki, whose 14-year-old son has severe food allergies, said the
bloggers supported Mylan because they believed it "had our back and
manufactured a device that we couldn't live without."
Mylan declined to discuss Rudnicki's criticism. The company
confirmed she resigned, adding it had thanked her for her work.
Some bloggers like Caroline Moassessi, a food allergy activist from
Reno, Nev., take a more nuanced view.
She attended three summits and testified in Nevada to allow schools
and other public venues to stock epinephrine.
She also has felt the full effect of price hikes. As a small
business owner, she paid $3,000 in 2015 for EpiPens for her son and
daughter. Each child carries two pens at all times and keeps two
more at school. Moassessi also carries two injectors.
While Moassessi would rather pay less, she said she recognizes that
Mylan is in business to make a profit.
"I know they're a business trying to make as much as they can, like
Ford, Chevy, Macy's," she said. "I'm not naive about that,
whatsoever."
(Reporting by Dave McKinney; Editing by Michele Gershberg and Lisa
Girion)
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