Gayle Manchin
CHARLESTON, W.Va. — USA Today reported Tuesday that Gayle Manchin, mother of Mylan CEO Heather Bresch, used her former position as head of the National Association of State Boards of Education to spearhead “an unprecedented effort that encouraged states to require schools to purchase a drug” that Bresch’s company sells.
Manchin, West Virginia’s former first lady, became a state Board of Education member in 2007 after her husband, and Bresch’s father, Democratic U.S. Sen. Joe Manchin, appointed her to the position when he was governor.
She served as president of the state school board from 2013 to 2015 and she’s still a member, although she hasn’t shown up at board meetings in recent months. Manchin’s term expired in November and she previously has asked Gov. Earl Ray Tomblin to replace her, but he has yet to do so — board members can continue to serve until the governor names a replacement.
“The association’s move helped pave the way for Mylan Specialty, maker of EpiPens, to develop a near monopoly in school nurses’ offices,” the news outlet reported. “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.”
The USA Today article detailed an apparent lack of awareness among association members about the connection between Manchin and Mylan. Alan Taylor, the association president Manchin succeeded, told the newspaper that he didn’t recall knowing about the link.
The EpiPen is an auto-injection device containing epinephrine, a drug that treats people with life-threatening allergic reactions. USA Today reported that the EpiPen is “about the only auto-injector for the drug epinephrine.”
Mylan has been facing heat — including a subpoena from West Virginia Attorney General Patrick Morrisey and a hearing today for Bresch before a congressional committee — regarding the dramatic rise in the price of the EpiPen, which cost about $100 in 2009, but has increased to more than $600 since then.
West Virginia doesn’t have a law or state school board policy requiring schools to stock epinephrine. However, the school board does have a policy, which it passed during Gayle Manchin’s time as president of that board, allowing schools to stock the drug for emergency use on students who aren’t prescribed it.
Before the school board earlier this month approved schools stocking naloxone — a drug, often known by the trade name Narcan, that can save people from overdoses on heroin and other opioids — epinephrine was the only drug schools could stock in such a manner.
Separate from the stocked drugs, parents can purchase more EpiPens and other drugs students might require throughout the day, such as insulin, and provide them to schools to administer to their children.
USA Today reported that Manchin didn’t respond to requests for comment for its story, and she didn’t answer a call Tuesday from the Gazette-Mail. She did release a statement Tuesday via email through state Department of Education spokeswoman Kristin Anderson.
“As a mother, grandmother, and educator, my first concern is the life and well-being of all children,” Manchin stated. “After the death of a child in school from anaphylactic shock, I felt it was my responsibility to do everything I could to prevent this from ever happening again. I also felt it was necessary to educate students, parents and school health nurses on medical options available for the dispensing of epinephrine in case of emergencies.
“My only concern and motivation, was, and always will be, how we can protect as many children as possible.”
“It just looked so bad to me,” Brenda Welburn told USA Today. “She [Manchin] becomes president and all of a sudden NASBE is saying EpiPens are a good thing for schools.”
In Manchin’s first year as president, the newspaper reported, Mylan sponsored, at the association’s annual conference, health presentations, including one concerning food allergies that had, as a presenter, an allergy doctor who has received hundreds of thousands of dollars from Mylan for research. The article quoted the moderator of two panels at that conference as saying she wasn’t aware of the Mylan funding.
USA Today reported that, around the same time, Mylan launched its EpiPen4Schools program, which provided “more than 700,000 free EpiPens to 65,000 schools, about half the nation’s schools” and has become the subject of the New York attorney general’s investigation. The newspaper reported that the program “required schools to buy EpiPens rather than its competitors if they got discounted versions, but Mylan has since changed the policy.”
The article also reported that, at the end of Manchin’s first year as president of the association, “the association announced an ‘epinephrine policy initiative’ designed to ‘help state boards of education as they develop student health policies regarding anaphylaxis and epinephrine auto-injector access and use,’ according to a press release that month.”
“It was the first time the group had addressed food allergies as policy despite its own admission that it had been a growing issue since about 2000,” USA Today reported.
Brenda Isaac, the lead school nurse for Kanawha County, West Virginia’s largest school system, said she recalls Mylan — which declined that “the company’s efforts were anything but straightforward” in a response to USA Today — had pushed hard to get a law passed in West Virginia that paved the way for the state school board policy allowing epinephrine stocking.
She said Kanawha currently stocks four EpiPens in every school — in addition to the ones prescribed for students — and the current ones expire in October 2017. She said Mylan initially said it would provide two free years worth of EpiPens, and when she contacted the company in October of last year, it agreed to provide a third year free.
She said the Kanawha Dental Health Council had paid $112 per EpiPen two-pack, a discounted rate, to stock them in the county’s seven school-based dental health clinics over concerns about allergic reactions to medications the clinics use.
Isaac said that while Kanawha hasn’t used any stock EpiPens over these three years, she said the drug is “lifesaving, so you can’t afford not to get them.”
But when asked if Kanawha would continue stocking the drug if Mylan started charging, she said: “I’d have to talk to my supervisors and look at how much it was going to cost,” suggesting the supply might have to be limited to giving them to each of the 35 school nurses who serve the county’s roughly 70 schools.
“Obviously, I can go to the superintendent and ask for more money, but that’s a lot of money for something that I’ll probably throw away in a year,” Isaac said.
“You don’t want to take a chance on not having the medication if you need it, because you don’t want to take a chance on 911 getting there in 10 minutes, or sometimes you might not even have 10 minutes because you don’t know what is happening,” she said. “It goes way beyond just the school system and, in all fairness, Mylan has worked very hard to make sure schools are supplied with what we need, and that’s appreciated.”
Reach Ryan Quinn at [email protected], facebook.com/ryanedwinquinn, 304-348-1254 or follow @RyanEQuinn on Twitter.
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