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This Oct. 10, 2013, file photo, shows an EpiPen epinephrine auto-injector, a Mylan product, in Hendersonville, Texas. Mylan reports financial results Tuesday, Aug. 9, 2016. (AP Photo/Mark Zaleski, File)

Why the huge price boost for EpiPens is so complicated for Congress (and everyone else)

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EpiPens used to cost $57 a shot. Now it costs more than $600 for a pack of two.

That's drawn a lot of attention lately, and even Congress is demanding answers from the CEO of Mylan, the corporation that sells the EpiPen.

The catch: That CEO, Heather Bresch, is the daughter of Senator Joe Manchin (D-WV).

It only gets trickier from there.

Generic for Adrenaclick® Firing Demo

What's an EpiPen, anyway?

It's a an epinephrine injector filled with epinephrine that can save your life if you have serious allergies. People with bee and food allergies are most likely to rely on them.

WATCH:  You can see above what it looks like to use one.

That seems pretty good. So the problem is...

The School Access to Emergency Epinephrine Act was passed in 2013, which encourages states to require schools to keep emergency epinephrine on hand. Mylan spent $4 million in lobbying for that law.

Taxpayers are going to have to foot the now-huge bill for additional EpiPens. Mylan gave away 700,000 EpiPens, but that won't be enough. And families that rely on EpiPens have no choice but to keep paying.

Heather Bresch.jpg
FILE - In this April 8, 2008, file photo, Mylan Pharmaceuticals CEO Heather Bresch poses for a photo in her office in Canonsburg, Pa. Bresch was one of the highest-paid women CEOs for 2015, as calculated by The Associated Press and Equilar, an executive data firm. (AP Photo/Dale Sparks, File)

And  CNBC reports  Mylan isn't exactly hurting for cash. Since it bought the EpiPen, Bresch's total compensation increased from $2.5 million to almost $19 million. 

I'm outraged! Who do I get mad at?

Most people are targeting Mylan, which sells the drug. And its CEO is Heather Bresch, whose family ties are drawing unwanted attention.

Members of Congress are taking action. Sen. Richard Blumenthal (D-CT) asked Bresch in a letter to explain the "shocking price increase."

But by Tuesday, he deflected questions about Bresch with "no comment," Bloomberg reports. He's still holding an event on Wednesday calling on the Senate and the Federal Trade Commission to investigate alleged shady dealings.

The recent price increase for EpiPens places a financial burden on those who desperately need this drug.
Sen. Elijah Cummings (D-MD)

Sen. Amy Klobuchar (D-MN) is also asking the FTC whether Mylan has been blocking competitors. There's an EpiPen alternative called Adrenaclick that is much cheaper -- you can get a 2-pack for $142, according to GoodRX. But it still hasn't sold well.Manchin is expected to recuse himself from any investigations.

Hillary Clinton condemned the price increase in a statement Wednesday afternoon.

Even Bernie Sanders spoke out against the move.

Martin Shkreli.jpg
FILE - In this Feb. 4, 2016 file photo, pharmaceutical chief Martin Shkreli speaks on Capitol Hill in Washington during the House Committee on Oversight and Reform Committee hearing on a decision by his former company, Turing Pharmaceuticals, to significantly raise the price of the anti-parasitic medication Daraprim. A bill awaits Vermont Gov. Peter Shumlin's signature in May 2016 that would make it the first state requiring drug companies to explain their price increases. The legislation would have regulators develop an annual list of up to 15 drugs that have seen the biggest price increases. Manufacturers then would have to justify the increases to the attorney general's office. (AP Photo/Susan Walsh, File)

This all sounds kinda familiar

Remember Martin Shkreli, the "Pharma Bro" formerly of Turing Pharmaceuticals who jacked up the price of an HIV and malaria drug from $13.50 to $750 overnight?

Mylan is the good guy. They had one product, and they finally started making a little bit of money and everyone is going crazy over it.
Martin Shkreli

Even he condemned Mylan, calling them "vultures." But he also told NBC News his company had also considered a gradual price increase but settled on a drastic shift.

He also, somewhat confusingly, defended Mylan to CBS News.

And there are many more example of huge price increase. Here's a few from The Hill in recent years:

  • Colchicine, which treats gout, has increased from $18 per gram to $578
  • Digoxin, which treats heart problems, went from $0.88 per 100 milligrams to $78
  • Carac, which treats skin cancer and other skin conditions, went from $402 for 30 grams to $2,425.
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