"We understand the deep frustration and concerns associated with the cost of EpiPen to the patient, and have always shared the public's desire to ensure that this important product be accessible to anyone who needs it," Mylan chief executive Heather Bresch said in a statement. "Our decision to launch a generic alternative to EpiPen is an extraordinary commercial response."
Joshua Sharfstein, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, called it a face-saving move by the company. The generic offers a way of dropping the price of one version of the drug, while also bringing the company some benefits. It will allow Mylan to segment the market, because some people will continue to buy the brand-name product.
Sharfstein said one important question will be whether the price stays the same over time.
The introduction of Mylan's generic also won't automatically open the window to true competition from other generic companies, according to Michael Carrier, a professor at Rutgers Law School. Companies can introduce generics of their brand-name drugs, called "authorized generics," but the effect on competition is ambiguous, he said.
"We have more competition than we did yesterday, but on the other hand, we don’t have wide-open competition among the generics," Carrier said. "And maybe by having this authorized generic, we’re keeping at bay some of that true competition."
He noted that when the first generic drug enters the market, it usually gets a very shallow discount off the brand-name list price — maybe 5 or 10 percent. It is only when multiple generics enter that deeper discounts occur. The deep initial discount off the brand-name price could make the market less attractive to generics companies.
"I think that’s what we've seen over the past week, where Mylan realizes it is in political hot water, and so it is doing a whole bunch of things to make it seem like it’s lowering the price — and for some consumers it will help," Carrier said. "These are measures that Mylan is taking to lower the price, but notice it has not lowered the list price of the drug at all."
Sen. Richard Blumenthal raised the same question in a statement.
"Mylan may appear to be moving in the right direction, but its announcement raises as many questions as solutions — including why the price is still astronomically high, and whether its action is a preemptive strike against a competing generic," Blumenthal (D-Conn.) said.
Teva Pharmaceutical Industries has been trying to launch a generic version of the drug, but it was rejected by regulators earlier this year for "certain major deficiencies," according to a spokeswoman, and product launch has been delayed until at least 2017.
Public Citizen, a patient advocacy group, noted that not everyone will get access to the generic, making it an incomplete solution to the high price — similar to the critique leveled at the coupons and patient assistance.
"The weirdness of a generic drug company offering a generic version of its own branded but off-patent product is a signal that something is wrong," Public Citizen President Robert Weissman said in a statement. Mylan "aims to continue ripping off some segment of the marketplace — both consumers who do not trust or know about the generic, and perhaps some insurers and payers constrained from buying a generic."
He noted that the price in Canada is $200 for a two-pack of EpiPens and that the price in France was even lower.