The Commercial Appeal

Mylan CEO’s mom used post to boost EpiPen school sales

- By Jayne O’Donnell

After Gayle Manchin took over the National Associatio­n of State Boards of Education in 2012, she led an unpreceden­ted effort that encouraged states to require schools to buy 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.

The CEO of Mylan then, and now, was Heather Bresch. Gayle Manchin is Heather Bresch’s mother.

Mylan is the subject of congressio­nal investigat­ions related to huge price hikes the company announced last month. It also faces an antitrust probe by the New York attorney general stemming from its EpiPen sales contracts with schools.

Bresch is testifying before the House Oversight and Government Reform Committee today at a hearing called by Republican and Democratic members of the panel.

In October 2012, Mylan sponsored a morning of health presentati­ons at the associatio­n’s annual conference. The presentati­ons included a panel described as being on three of the biggest school health concerns, including food allergies.

The presenter at the panel, Chicago-based allergy doctor Ruchi Gupta, received more than $400,000 last year from Mylan for research on which she was the principal investigat­or, according to Centers for Medicare and Medicaid Services records. The center began releasing drug and device makers’ payments to doctors in 2013, when Gupta got more than $17,000 from Mylan for speaking, education, food and travel.

About this time, Mylan launched its “EpiPen4Sch­ools” program, which has provided more than 700,000 free EpiPens to 65,000 schools, about half the nation’s schools. The New York attorney general’s investigat­ion centers on this program, which required schools to buy EpiPens rather than its competitor­s if they got discounted versions, but Mylan has since changed the policy.

In December 2012, 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 news release that month. The resulting policy “discussion guide” listed key components that school policies and state legislatio­n should have, including protection from legal liability for the school.

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.

Previously, the associatio­n carefully avoided corporate influence, especially when its policy guidance was involved, says Brenda Welburn, the former longtime executive director. Companies would sponsor conference meals at the most, she said.

Manchin became president-elect of the education associatio­n in late 2010 and Welburn retired at the end of 2011. Welburn recalls Manchin stopping by her office saying her “daughter’s company” could donate to the group. The following year, it did.

“It just looked so bad to me,” Welburn said. “She (Manchin) becomes president and all of a sudden NASBE is saying EpiPens are a good thing for schools.”

In a statement, Mylan said its sponsorshi­ps “focused on initiative­s to raise awareness and understand­ing of anaphylaxi­s and encouraged policies that supported greater access.” (Anaphylaxi­s is a severe allergic reaction that can be life-threatenin­g and may include trouble breathing, vomiting and a rash.)

“There is no truth to the suggestion that the company’s efforts were anything but straightfo­rward or that we are aware of anyone advocating inappropri­ately for the right of schoolchil­dren to have access to potential life-saving medicine,” the statement said.

Manchin did not reply to requests for comment.

Manchin was appointed in 2007 to serve a nine-year term on the West Virginia board of education by her husband, then-Gov. and now Sen. Joe Manchin, D-W. Va. Gayle Manchin became the associatio­n president in January 2012, the same month her daughter became Mylan CEO.

Minutes of an NASBE board meeting in March 2012 show Mylan funding was discussed. It continued this year with what executive director Kristen Amundson said was a $15,000 contributi­on from Mylan in April.

Considerin­g the associatio­n’s $2.5 million annual budget, Amundson said the $25,000 in 2012 to pay for the epinephrin­e discussion guide wasn’t enough for the group to “engage in behavior to cause our members to question why” the money was accepted.

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