Why Have EpiPen Costs Spiked 5-6X in 12 Years?


Image Credit: Mylan(R)

Pharma Bro Martin Shkreli isn’t the only one charging new prices for old medicine. It appears that Mylan, the manufacturer of the EpiPen, has increased the price of its emergency epinephrine injection 5-6X over the last 12 years, according to this article in Slate.

It is true that EpiPen can be a lifesaver in a food allergy emergency that causes anaphylaxis. However, this was also true 12 years ago, and it appears that the technology and medication have changed little in the interim.

So what changed? Marketing that turned this modest medication into a billion-dollar profit center. (Mylan offers a co-pay coupon for prescriptions, but many people still pay too high a price and risk their lives with cheaper and riskier ways to inject emergency epinephrine.)

Hopefully, Teva (and other generic drug companies) will soon be able to market a safe and (cost) effective alternative for the captive market of anaphylactic consumers.

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Tip Skimming from Waitstaff is a Serious and Under-Reported Problem

Food safety is about more than just pathogens and pesticides. It’s also about making sure that the people who grow, process, cook, and serve our food have safe working conditions and are treated fairly:


Image Credits: Los Angeles Coalition Against Wage Theft (available at UCLA Labor Center website).

Tips provide a substantial portion of restaurant workers’ income. However, some management personnel unlawfully take some or all of those tips. Please see my new article about tip skimming in the June 2016 issue of Plaintiff Magazine to learn more about the under-reported problem of wage theft.


Shigella Food Poisoning Outbreak Closes San Jose Restaurant

October 22, 2015 1 comment


(Photo credits: http://www.mercurynews.com/health/ci_28995979/update-dozens-sickened-12-intensive-care-after-eating; KGO ABC 7 News.)

The Santa Clara County Health Department has closed Mariscos San Juan, a San Jose, California seafood restaurant due to a Shigella food poisoning outbreak that has sickened more than 90 people.

What is Shigella?

Shigellosis is an infection caused by Shigella bacteria.  Symptoms usually appear within 1-2 days after infection.

How Bad Is It?

Diarrhea, abdominal pain, and fever are common symptomsChildren and immuno-compromised people are most at risk of infection.

Shigella complications are rare, but they can be serious.  They include Hemolytic-Uremic Syndrome (HUS) that can cause acute kidney failure and reactive arthritis.  

How Does It Spread?

Although no specific source of contamination has been identified in this outbreak, there are multiple possible sources of shigella infection, which is highly contagious.  These include:

How is It Treated?

Diarrhea can cause dehydration, which can be treated with fluids.  Serious cases may require additional medical treatment such as antibiotics.

Why Should I Worry About It?

Shigella is prevalent, causing about 500,000 cases annually in the U.S.

Shigella bacteria are also developing resistance to many common antibiotics, which makes the condition harder to treat and more likely to spread.

What Can I Do About It?

Shigella victim Greg Meissner filed a lawsuit against the restaurant.  Given the number of people infected, more will likely follow.

Followup Re: GMOs and the Pesticide Arms Race: EPA Considering Testing Food for Roundup Residues

 (Photo Credit: zengardener.com. Trademarks and copyrights are property of their registered owners.)

As reported by Reuters and Food Safety News, the EPA is considering testing food products for residues of glyphosate, also known by the Monsanto brand name, Roundup.

The EPA has only tested for glyphosate in one year, 2011.  Although most soybean samples tested contained residues, all were below the exposure limit.  However, exposure to glyphosate occurs from a wide variety of products, so some consumers are concerned even about what appear to be relatively low levels, such as the 0.12 ppm found in the kids’ cereal, Froot Loops, and the .05 ppm found in organic honey.

Given the pervasive application of Roundup to non-organic crops and recent research supporting the hypothesis that glyphosate increases antibiotic resistance, testing for residues is a good first step.

GMOs Accelerate the Pesticide Arms Race

April 18, 2015 2 comments

No GMO (Photo credit: Liam Wilde)

I hold Bill Nye in high regard for all he has done to raise public awareness of important scientific issues.  However, I respectfully disagree with his love of GMO foods for at least four reasons.

(1) The Pesticide Resistance Arms Race:

“Roundup Ready” crops have been genetically modified to withstand exposure to glyphosate, the generic name for Monsanto’s Roundup, “the largest crop protection brand” in the world.  Farmers that grow Roundup Ready crops had every incentive to use it to kill weeds without apparent harm to the crop.  (From 1996 to 2006, Roundup use increased six-fold.)

The problem: Roundup “worked spectacularly well — until it didn’t,” because weeds have developed resistance to it.

The purported solution: crops genetically modified to withstand exposure to more toxic and persistent pesticides like 2,4 D, a major component of Agent Orange linked to numerous cancers and other serious health problems.  (Although some sources claim that the problems with Agent Orange arise from another ingredient, 2,4,5-T that has been banned in part because its production is contaminated with Dioxin, 2,4-D can also contain Dioxin.)

Dow’s Enlist Duo herbicide contains both glyphosate and 2,4 D.  Question for Dow: how long will this “weed control system” actually control weeds, and when will you start selling Enlist Trio, Enlist Quattro, etc.?  Although using higher concentrations of more lethal pesticides may keep weeds at bay temporarily, over time, this overdose will only result in creating an even greater superweed problem.  Monsanto, Dow, and other companies that sell GMO seeds resistant to their pesticides profit from the pesticide arms race, but I have yet to see evidence that increased exposure is good for my family’s health.

(2) Farm Workers Exposed to Higher Amounts of More Toxic Pesticides:

Farm workers are routinely exposed to far higher levels of pesticides than consumers, which can cause these workers to develop acute and chronic health problems.  Choosing to eat pesticide-free foods is a market-based solution to getting off of the “chemical treadmill” and reducing their exposure.

(3) Higher Pesticide Exposure = Lower Fertility:

A recent study found that men who ate foods with more pesticides had lower sperm counts and fewer normal sperm.

(4) GMOs Feed Shareholder Profits; They Are Not Used to “Feed the World”:

Fun fact: GMO crops do not have higher yields than conventional ones.  But they do have higher profits for the GMO seed companies, at the expense of farmers.

If Dow, Monsanto, and their competitors dedicated, say, 20% of their GMO R&D budget to reducing the $1 trillion of annual food waste, why would we purportedly need GMOs to “feed the world“?  Because profits.  You probably can’t aggressively enforce a patent on public service announcements re: how to reduce food waste.

“Natural” Food and Artificial Injustice – Toward a Fair Liability Standard

Please see my recently-published article in Plaintiff Magazine regarding the liability standards that apply in California for food-related personal injuries.

The Mexicali Rose decision allows plaintiffs to state some previously non-cognizable negligence claims against restaurants that serve injury-causing food.  Mexicali Rose v. Sup. Ct. (Clark), 1 Cal.4th 617, 621 (1992) (“Mexicali Rose”).  However, if the injury resulted from a substance that was “natural to the preparation of the food,” then strict liability and breach of warranty claims remain barred.  Id. at 630.

In light of food processing and safety changes that have occurred since this 1992 decision, the artificial, vague, and unworkable distinction between foreign and purportedly natural substances should be overruled.  A fair measure of justice should be available for all consumers, based on their reasonable expectations for the food served.

“Good Things Come From Sysco” (Allegedly Via Unrefrigerated Storage Lockers)

NBC Bay Area has reported that foodservice giant Sysco allegedly kept perishable foods in unrefrigerated storage lockers for several hours before delivering them to customers.

If these allegations are true, they raise multiple issues regarding food safety and quality.  Most laypersons know that perishable food like milk and meat must be stored at proper cold temperatures to maximize food safety and minimize the growth of many dangerous pathogens.  The USDA recommends discarding many perishable foods that have been held above 40 degrees F for more than two hours.  Sysco clearly understands these concerns, as it (1) presents ServSafe “state-of-the-art food safety training” and (2) tells investors all about the high technology used in its climate-controlled warehouses.

Refrigeration is also critical to maintain food freshness throughout its recommended shelf life.  Perishable foods that have been subjected to temperature abuse rapidly degrade in quality, so buyers may not be getting all of the freshness they paid for.

This also raises an issue of unnecessary food waste.  Even utilizing modern temperature controls, each year, Americans throw away almost half of their food, worth an estimated $165 billion.  This means more than just people going hungry; it wastes massive amounts of water, land productivity, and energy.  Sysco represents that it takes its sustainability responsibility “seriously.”

So how can buyers protect themselves from temperature-abused food that might look just fine when it is delivered?  Technologies like RFID provide data to verify proper holding temperatures throughout the supply chain, but they are not used as widely as they could be.

If the allegations are proven, “Sysco faces misdemeanor criminal charges and a one thousand dollar fine for each violation,” not including possible customer lawsuits.

Why is Food Fraud Pervasive? Follow the Money.

January 7, 2013 1 comment

NPR recently reported that a sushi chain owner in Japan paid $1.76 million for just one (489 pound) bluefin Tuna.  Per pound, that is more than the price of “the very best connoisseur cannabis” in California.  With such strong economic motivation and weak criminal penalties, is it any wonder that 39 percent of fish sold in the U.S. is mislabeled?

Food Fraud: More Than Just Economic Injury

Do you really know what kind of fish you’re eating?” And why that’s such an important question?

As recently reported in Food Safety News, food fraud (by way of species substitution) presents more than a risk of ripping off consumers.  Pregnant women may be unwittingly exposed to toxins, gastric distress, and allergens from consuming seafood that is not what it purports to be.  Honest employees of fishing companies, distributors, and retailers that sell genuine products can lose sales and their jobs.

U.S. Senator Barbara Boxer (D-CA) recently asked the FDA to increase its efforts to reduce seafood mislabeling.  For bad actors, increased “traceability and enforcement . . . from bait to plate” presents risks of criminal prosecution and civil damages from class action litigation.  However, for seafood companies that adopt best practices, it also provides promotional and marketing opportunities.

Country of Origin Labeling (COOL) Fraud: A Worldwide Problem

Today’s edition of Dairyreporter.com reports that numerous Chinese infant formula manufacturers are allegedly falsely claiming that their products were manufactured in New Zealand.  At least one company, Abid, allegedly falsely claimed a product endorsement from Prime Minister John Key.

Why is this Happening?

Chinese consumers are willing to pay a premium price for NZ baby formula due to its perceived safety and quality advantages over Chinese-made products.  Chinese consumer confidence in the safety of domestically-produced food has declined over the last year, and dairy products are the number one imported food in the country.  In just June and July 2012, Chinese firms recalled infant formula and milk products contaminated with mercury, aflatoxin, and lye.  These recent problems demonstrate that the country still needs to improve its food safety and quality after the 2008 melamine-contaminated infant formula disaster that implicated 22 companies.

Why should my Company Care about COOL Fraud?

Companies should consider proactively addressing country-of-origin labeling (COOL) fraud to reduce the risk of brand dilution, lost sales, and injuries to their customers.  New Zealand has a top-three country brand name.  Some of its manufacturers are specifically marketing their products as being “safe” or “tamper proof,” based on the country’s strong food safety and environmental standards.  Higher Western food safety standards present an opportunity to boost sales to Chinese consumers.  COOL fraud also may present risks of civil and criminal liability as well as conviction in the court of public opinion.