Winner of the Fall 2019 StMU History Media Award for

Best Article in the Category of “Gender”

Have you heard of EpiPens? Mylan is the company that produces these devices that deliver epinephrine to people having severe allergic reactions. Mylan Inc. is one of the world’s largest leading manufacturers of generic drugs. The company produces and markets specialty, brand-name pharmaceutical products mainly for the respiratory, severe allergy, and psychiatry markets. Founded in 1961, it was previously named Milan Pharmaceuticals, Inc after cofounder Milan Puskar. However, after management disputes, Puskar left the firm and the company changed its name to Mylan Laboratories Inc. Eventually, Mylan went into bankruptcy in 1976 which meant that the company needed new leaders, so Puskar rejoined as president. Puskar kept this role for 48 years until he retired in 2009. During that year, Heather Bresch was promoted from COO, Chief Operating Officer, to president and took responsibility for the company’s daily operations.¹ Bresch kept this role until 2012 when she was promoted from president to CEO, Chief Executive Officer. This made her the first female CEO in Mylan’s history.²

Bresch grew up in a small town in West Virginia in a close family with a strong work ethic. She joined Mylan in 1992 as an entry-level clerk performing basic administrative tasks in the basement of Mylan’s manufacturing facility. After that, she worked in 15 different roles in the company before becoming CEO. When she started with Mylan, the sales were approximately $100 million and they had fewer than 500 employees, and since she became CEO, the sales have drastically increased to $11 billion with more than 40,000 employees working for the company.³

Even though Mylan has had some positive accomplishments in recent years, the company has also been in the spotlight. For example, Robert J. Coury, Mylan’s chairman who served as chief executive until 2011, was under fire in 2012 for using the company’s jet to travel to his son’s concerts. Also, The Wall Street Journal reported that one of the board members of Mylan had secret ties to the land where the company built its new office. Bresch has also been in the spotlight when it was discovered that West Virginia University awarded her with a business degree ten years after she had attended the university, even though she had completed only about half of her degree plan. An investigation concluded that officials awarded her the degree because she was the daughter of the former governor, Joe Manchin. However, Bresch still claimed that she had done nothing wrong. Also, Bresch’s rising salary has caused disputes and outrage due to the increase in EpiPen prices. Prior to Bresch being CEO, when she was the COO, her salary was about $2.5 million. In 2015, she was making about $19 million each year. The board says this is due to the significant contributions that she has made to the growth of the company but the public is still furious as they see the increase in EpiPen prices leading to Bresch’s huge pay raise.⁴

Bresch’s career has risen since she first started working in the basement to the CEO’s office. Bresch was newly married in the early 1990s and moved from California to West Virginia for a job. Her father, ran into his friend Milan Puskar at a sporting game and was able to get her an interview at Mylan. Bresch got a job typing labels in the factory basement. In 2002, Bresch got her first major job in the company as a director of government relations. In 2003, Mylan praised Bresch for her work with Congress as they passed a major Medicare overhaul. During 2003 to 2007, Bresch’s role with Mylan kept advancing as she took on roles including spokeswoman, head of strategic development, head of North American Operations, Chief Integration Officer, and Chief Operating Officer. After the controversy involving Bresch’s degree from the University of West Virginia, she became president of Mylan in 2009. In 2012, Bresch became the CEO of Mylan and was the only woman to ever run a Fortune 500 pharmaceutical company.⁵

Currently, approximately 25% of the United States CEOs are female. Due to the small number of female CEOs, they tend to face many difficulties compared to male CEOs. A report determined that women leaders were more likely to lose their jobs through downsizing than men. Also, 19% of senior female leaders reported being laid off from their job while only 6% of senior male leaders were laid off. Despite being underrepresented for some time, female CEOs ranked higher in 42 of the 52 skills that measured dimensions of motivating others, fostering others, listening to others, and communication, while male sometimes earn higher marks in critical areas such as strategic ability and technical analysis. To elaborate, female executives were judged as more effective than male executives due to the slightly lower rankings of men. Women have reported unfair treatment in promotions, a lack of appreciation for their talents, and disregards to issues typical to female managers. Also, another difficulty that female CEOs face is the stereotypes associated with women such as that they do not fit male stereotypes of leadership skills which includes the pitch and tone of their voice, their physical appearance, and their clothing. These perceptions often serve as barriers as females try to advance to CEO positions. Bresch, however, has overcome these barriers and has made positive impacts on Mylan. ⁶ 

One of Bresch’s biggest accomplishments was buying the EpiPen in 2007. This led to the increase in sales for EpiPens. She even refers to it as, ‘my baby’ since in 2014, it became Mylan’s first billion dollar product which is a rare achievement for a generics company. Also, Bresch has overseen a major revenue increase. Mylan sales improved, selling up to $10.1 billion in 2015, and they were previously at $6.1 billion in 2011 before she became CEO. In 2015, Bresch became the most powerful woman in the drug industry. Since Bresch took on the role as CEO, the corporation has more consistently met earnings expectations and its stocks are up 124%. However, with Bresch’s accomplishments, she has earned hate due to the negative impact that she has left on the company.⁷

Bresch and Mylan face dramatic controversy over the drastic increase in EpiPen prices. In 2016, Mylan raised the price of EpiPens from about $100 to $600 per EpiPen. This issue even made its way in the 2016 presidential election since many Americans think prescription drug costs are unreasonable and believe that the government should address the issue.⁸

EpiPens treat anaphylaxis, which is a life-threatening allergic reaction often caused by food, medication, insect stings, or latex. Anaphylaxis is an overreaction to an allergen caused by the body’s production of an antibody called immunoglobulin E, or IgE. When a person comes in contact with their allergen, the person’s immune system produces IgE antibodies that are specific to the allergen. The IgE antibodies attach themselves to the surface of mast cells. Mast cells are specialized cells that lie in the connective tissue near the blood vessels. The next time the person encounters the allergen, the IgE antibodies will trigger the release of a compound called histamine from the mast cells. This causes tissues to swell, difficulty breathing, and other symptoms of anaphylaxis. In addition, histamines cause the blood vessels to expand which lowers blood pressure. It also causes fluid to leak from the bloodstream into the tissues, which leads to hives and a decrease in blood volume. Additionally, fluid can leak into the air sacs in the lungs and make it difficult to breathe. People with allergens experiencing symptoms like these should be administered adrenaline, also known as epinephrine, which is a hormone that counteracts the effects of histamines. EpiPens provide Epinephrine by injection, which increases the chances of a person with allergens living during an anaphylaxis shock is high. About 30,000 people are taken to hospital emergency rooms with an anaphylactic reaction in an average year. There are approximately 500 and 1,000 deaths from anaphylaxis each year in the United States.⁹ Many of these deaths occur because some people cannot afford an EpiPen.

In 2019, prices of EpiPens are still high. However, Mylan’s marketing strategy is still proving successful. In the years since it acquired the EpiPen, revenues increased from $200 million to more than $1 billion. This device alone provides roughly 40% of Mylan’s operating profits. Although the medicine in an EpiPen costs only pennies per dose, but these units need to be replaced each year and some families need more packs just to be safe. Each pair of Epipens costs people more than $600 each.  However, Bresch has made plans to make sure that people with allergies have access to an EpiPen. For example, Bresch has encouraged schools nationwide to carry EpiPens. Also, Mylan is working to allow restaurants and hotels to have access to an EpiPen. The company has even signed a deal with Walt Disney to stock EpiPens in Disney’s theme parks and on cruise ships.¹⁰ With Bresch as CEO, Mylan has reached more milestones than any other time in the company’s history. The pushback from the drastic price increase of EpiPens has not hampered the profitable direction the corporation has taken since Bresch took the role as CEO. Despite these controversies, the company’s revenues prove that Bresch has successfully represented females in a male-driven business.