“Ever since I’ve been in this position, and when I was governor, we made a point –we just didn’t get involved. It’s so convoluted, I don’t understand. To get into something you don’t understand and your daughter being in this type of industry – it was best I stayed away. My daughter is my daughter with unconditional love, and she’s the most amazing person that I know. She’s so compassionate and generous in how she’s always lived her life.”—Senator Joe Manchin, whose daughter, the CEO of Mylan, had raised the price of EpiPens by 500% between 2007 and 2016.
EpiPens are life-saving devices for people who can go into anaphylactic shock after exposure to certain substances (peanuts, the venom in a bee sting, latex). It costs pennies to produce the medicine in an EpiPen —it's epinephrine, a synthesized version of adrenaline, the hormone made by our bodies. The EpiPen has a patented spring-loaded mechanism that makes it unnecessary to draw medicine into a syringe prior to injection. Time is of the essence when a person is going into anaphylactic shock and dexterity may have been lost. Epinephrine loses potency over time and EpiPens have to be purchased annually.
The EpiPen is the product of taxpayer-funded research conducted in the 1970s by a company called Survival Technologies for the US military, which wanted an auto-injector device for soldiers facing potential exposure to nerve gas. The rights to market a civilian version to counter anaphylaxis were sold and re-sold by various drug companies: Survival merged with Brunswick which sold the rights to Dey, a subsidiary of Merck, which in 2007 sold the rights to Mylan, which made a production deal with King, a wholly owned subsidiary of Pfizer.
Mylan and King made some superficial improvements (a stronger spring, clearer instructions) and began a big marketing push in concert with unremitting price hikes. A key thrust was getting schools to keep EpiPens on hand. (Adults generally know what they're allergic to and try to avoid exposure or carry the antidote. Kids who've never had a severe allergic reaction are most at risk of a fatal response.)
As Governor of West Virginia in 2007, Joe Manchin had appointed his wife, to the state Board of Education. By 2012 she would be president of the National Association of State Boards of Education. In 2016 USA Today (a paper that doesn't get enough credit for its serious muckraking) reported that Gayle Conelly Manchin had "spearheaded an unprecedented effort that encouraged states to require schools to purchase medical devices that fight life-threatening allergic reactions.
"The association’s move helped pave the way for Mylan Specialty, maker of EpiPens, to develop a near monopoly in school nurses’ offices. Eleven states drafted laws requiring epinephrine auto-injectors. Nearly every other state recommended schools stock them after what the White House called the 'EpiPen Law' in 2013 gave funding preference to those that did."
Of course none of this was ever discussed when the Manchins' daughter Heather was in earshot. At Thanksgiving dinner it was all "Please pass the mashed potatoes, dad."
Heather's brilliant career was launched after Joe Manchin had "mentioned his daughter's job search" to the CEO of Mylan. Her rise was unimpeded by revelations that her claim to have a master's degree in business was a lie. The negative press she received when Mylan made EpiPens five times more expensive was eclipsed when a "pharma bro" named Martin Shkreli made an anti parasitic drug called Daraprim fifty times more expensive. She's a lucky woman and he's still doing time for securities fraud (but he owns the only copy of a record by Wu-Tang Clan).
Heather's annual income rose from $2.5 million in 2007 to $18.9 mil in 2015. Her accomplishments included Mylan's acquisition of Abbott Laboratories in 2014 and a transfer of corporate headquarters to the Netherlands, bringing the company's tax rate down from 24% to 21%. She retired in 2020 after arranging a merger with Upjohn. The moral of the story is that you don't really need an MBA to be a successful corporate executive.