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Is It Time for the USPSTF to Inform- But Not Determine- Coverage?

Authors: 
Moyer VA, LeFevre M, Calonge N
Year: 
2016
Journal: 
Annals of Internal Medicine
Abstract: 

Appendectomy is not a preventive service; neither is an EpiPen.

Mylan, the maker of the EpiPen, has heavily and successfully marketed this medical device with a resultant increase in demand. At the same time, the company has increased its price more than 5-fold over the past 9 years, resulting in stunning increases in revenue, as reported by The New York Times (1). The higher price, in concert with falling pharmacy benefits for many people, will inevitably limit sales and has courted the attention and disdain of national policymakers. While reducing the price is one answer to Mylan's current predicament, another approach—one that would protect profits—would be to enhance insurance coverage, increasing sales of the device and minimizing complaints about the price. However, insurance companies are also balking at the costs, and this approach faces significant challenges.