Mylan's branded ad spending on the EpiPen rose 357% — to $43 million in 2015 — over five years

Mylan increased its branded ad spending on the EpiPen by 357% over five years. During the same time the drugmaker hiked the price of the allergy auto-injector by 179%.

Mylan spent $43 million on branded ad spending for the EpiPen in 2015, down slightly from $48.9 million in 2014 and up significantly from $9.4 million in 2011, according to data from Kantar Media. The company's spending on unbranded ads, to raise awareness about anaphylaxis, a life-threatening allergic reaction that can occur in response to certain foods, insect stings, or latex, fell during the same five-year period, declining from $4.5 million in 2011 to $13,000 in 2015.

At the same time, the drugmaker has steadily increased the wholesale acquisition price, which excludes rebates and discounts, twice a year since 2011, according to Elsevier Clinical Solutions' Gold Standard Drug Database. In May 2011 the EpiPen was priced at $164.98, and that price rose to $461 by May 2015. It now costs $608.61.

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The drugmaker has been criticized by both lawmakers and advocacy groups for the pricing of its ubiquitous EpiPen. Earlier this week it announced plans to develop a generic version of the therapy that will cost half the price of the branded version after an expansion of its co-pay assistance program was also met with criticism. This did little to stem further scrutiny of a company that reported more than $1 billion in revenue for its EpiPen products and $9.4 billion in total revenue in 2015.

A spokeswoman for Mylan said the company had no comment.

The company's top-selling brands in 2015 were the EpiPen two-pack, at $1.2 billion, and the EpiPen Jr. two-pack, at $430 million. Mylan's device to dispense epinephrine isn't expected to lose patent protection until 2025. (Epinephrine is not protected by patents.)

“Mylan knows its $600/set of EpiPens is unsustainable, but 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,” Public Citizen, an advocacy group, said in a statement released August 29.

See also: The co-pay card debate simmers, as payers push back

The furor over the rising prices of EpiPens underscores the distaste felt by the public and payers over the drug industry's habit of raising the prices of old drugs. Drugmakers, which have also been criticized for the high prices of new drugs at launch, have argued that higher rates of cost-sharing for patients are to blame as more health insurance plans have moved to high deductibles and other forms of cost-sharing like high co-pays and co-insurance.  

“Because of the complexity and opaqueness of today's branded pharmaceutical supply chain and the increased shifting of costs to patients as a result of high deductible health plans, we determined that bypassing the brand system in this case and offering an additional alternative was the best option,” Mylan CEO Heather Bresch said in a statement announcing the generic version of the EpiPen.

A recent campaign for the EpiPen encouraged families to stock two auto-injectors rather than one. 

Until Mylan announced it would introduce its own authorized generic version of the anaphylaxis treatment, there was no cheaper option for healthcare providers to prescribe.  

Other recent attempts by drugmakers to bring a new epinephrine injector to market have failed. Sanofi tried to market its Auvi-Q devices in 2013, but they were quickly discontinued due to concerns over dosage. Teva Pharmaceutical Industries this year tried to introduce a generic version of the EpiPen, but the approval was delayed by the FDA in May when the agency cited “major deficiencies” in the company's application.

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Mylan acquired the EpiPen in 2007 from Merck KGaA. Since the acquisition, Mylan has promoted the therapy using back-to-school-themed programs and celebrities for awareness campaigns. The company's EpiPen4Schools program, which has provided free or discounted EpiPens to 56,000 schools, has also come under fire, with Stat reporting that schools had to agree to not purchase any other type of epinephrine injector that competes with EpiPen. Mylan has said this stipulation is no longer a part of the program.

In 2013, Mylan partnered with TV actress Julie Bowen for its awareness campaign: Get Schooled in Anaphylaxis. Then, in 2016, the company brought on actress Sarah Jessica Parker for Anaphylaxis For Reel, another anaphylaxis-awareness initiative. Sarah Jessica Parker later cut ties with the company, citing concerns over the price of the EpiPen.

Kevin McCaffrey contributed to the reporting.