After watching the Mylan EpiPen controversy unfold for the past few weeks, many problems have become glaring. While there are many thinkpieces that have highlighted these problems, our particular gripe is with the lack of innovative product design in medical equipment. We know the healthcare industry is capable of incredible innovation and design, so the question is, where is it? If the Mylan EpiPen has taught us anything, it's that we pay exhorbitant amounts of money for a product that made no improvements with every price hike, and we threw more and more money at it for the past eight years with nothing in return.
If you have not seen the da Vinci Robot stitch a grape skin back together, take a look at the oddly satisfying video that demonstrates minute robotic surgeries. Push aside the panic about the inevitable dominion of our robot overlords for a moment, and enjoy what an astonishing achievement this is for medical technology innovation. If all product design, equipment and technology in healthcare were like this in terms of design and functionality, then crazy price tags would make sense. In that vein, the EpiPen's hefty price tag REALLY doesn't make sense, and it speaks to a larger trend in medical equipment design.
1. HIGH PRICES FOR LITTLE OR NO INNOVATION
In healthcare product design, we have products and equipment that were engineered without the actual users in mind. Rather than taking notorious problems and eliminating them through design around the user experience, we have a system that intimidates many away from innovation because of the long bureaucratic process and prohibitive expenses.
When Mylan raised the cost of the EpiPen from $100 in 2008 to $600 by the time the controversy became national, it was for the exact same product without any improvements. At the very least, they could have improved the design to justify the price hike, but because there was no other real competition in the market, Mylan had a veritable monopoly for a product that had been widely marketed as essential for any parent, school, or person with severe allergies.
2. LACK OF DESIGN AROUND USER EXPERIENCE IN PRODUCTS
The glass ketchup bottle is iconic, but it was an inconvenient pain in the rear to use. You had to juggle optimal tilt and smacking force at the bottom to get an unpredictable amount of ketchup out. Yet we lived with this product design for decades, and still paid money for it. They redesigned their bottle with the user experience in mind, and lo and behold, not only do they win design awards for UX, they also increased their sales.
As Rasu Shrestha and others have articulately pointed out in the past, healthcare design has yet to consider a user-centric model when designing products. Long before the recent controversy surrounding the pricing of the Mylan EpiPen scandal, there were already complaints about its terrible design. Incorrect usage of the EpiPen has long been documented, and stems entirely from a poor design that was never improved upon. In short, people want to use it like a ball point pen by pushing the top, and they instinctively do so even after having been trained to do otherwise. The EpiPen could have easily taken its cue from typical user behavior and modified the design of the product to accommodate the instinctive reaction of a user.
This particular product problem hits so close to home for many, because nearly everyone nowadays knows someone with an allergy so severe, an EpiPen is necessary for controlling anaphylaxis. The effectiveness of that treatment is severely compromised every time it's used incorrectly, and a redesign of the product could completely change the experience so that it is deployed correctly every time. The stakes are higher with medical products for them to be used and deployed correctly and effectively, given that they are most often used in stressful emergency situations.
3. COSTS IN HEALTHCARE LACK TRANSPARENCY (AND COMPETITION)
The ridiculous cost of the EpiPen has meant that people risked using incorrect dosages in reaction to anaphylaxis if they simply opted for making their own epinephrine kits. Epinephrine is not an expensive drug. Indeed, many EMS teams and nurses have opted for making their own epinephrine kits rather than pay the $600 price tag. The EpiPen sells itself on its pre-dosed auto-injector delivery, something that costs them no more than $30 to manufacture with $1 worth of epinephrine.
The reason why some people were willing to pay the $600 price tag had more to do with Mylan's marketing towards peace of mind, the lack of a competitive generic product, and a long, expensive, bureaucratic process for new entrants in the healthcare market, which help create this circumstance. We cannot trust the market to correct itself with pricing if there is a stranglehold on options.
In the consumer market, products with great design get an edge over their competitors. They might not have any new innovations other than a re-design with user experience in mind, but that's often the only innovation needed to make a difference. Just like with the ketchup bottle, where it makes so much more sense to have a squeeze bottle rather than a glass bottle, we need more ketchup bottle redesigns in the healthcare industry. Simple, but so obvio
With that in mind, what frustrates you to use? Comment below!