Heather Bresch

Mylan executive

Manchin has had several executive roles at Mylan, senior vice president of corporate strategic development, head of North American Operations, chief operating officer, and chief integration officer.

Manchin led the integration of Matrix Laboratories Limited and Merck KGaA's generics and specialty pharmaceutical businesses with Mylan's operations. She was chair of the Generic Pharmaceutical Association (GPhA) for two terms. Manchin was appointed president of Mylan in 2009 and joined Mylan's board of directors in March 2011.

Manchin's appointment as chief executive officer (CEO) was announced in 2011, and she officially took the position in January 2012. Manchin was the first female CEO of a large pharmaceutical business. At the time, she was one of 18 female CEOs of a Fortune 500 company. After seeing how few female candidates were available for positions that require a background in science and math, she became more interested in promoting math and science education among young girls.

Manchin was recognized in Esquire's 2011 "Patriots of the Year" list for her work pushing for the Food and Drug Administration Safety and Innovation Act (FDASIA). She was named one of Fortune magazine's "50 Most Powerful Women In Business" in 2014.

Also in 2014, Manchin and Mylan announced a $5.3 billion acquisition of Abbott Laboratories as part of a corporate tax inversion plan to re-organize the company in the Netherlands and move its domicile to a country with lower taxes. Manchin said the decision was necessary to "maintain competitiveness against pharmaceutical manufacturers that had already executed similar inversion strategies." The company completed the complex tax inversion in February 2015. The inversion—which formally resulted in the creation of a new company, Mylan N.V., with 78% of its shares held by former Mylan Inc. shareholders and 22% of its shared held by Abbott Labs shareholders—was expected to immediately drop Mylan's U.S. corporate tax rate to 21% (from 24%) in the first year "and into the high teens over the next three to five years." The New York Times said that it was somewhat "disconcerting" for a company that benefits from large government contracts to renounce their citizenship for tax benefits. Proxy filings show that from 2007 to 2015, Manchin's compensation rose from $2,453,456 to $18,931,068, a 671% increase in pay.

EpiPen pricing and retirement

In 2016, Mylan's pricing of the EpiPen, used to treat anaphylaxis (severe allergic reactions), was severely criticized. Mylan had secured the rights to the nearly 50-year-old EpiPen as part of the Merck KGaA deal in 2007. At that time annual sales were around $200 million. Manchin launched an advertising campaign to increase awareness of "EpiPen" as a treatment for anaphylaxis; the company also successfully lobbied the FDA to broaden the label to include risk of anaphylaxis and in parallel, successfully lobbied Congress to generate legislation making EpiPens available in schools and other public places. The company hired the same lobbyists that Medtronic had used for its defibrillator legislation. From 2007 to 2016, Mylan increased the price of EpiPens by 461 percent, from about $100 for a package of two pens to about $600. By the first half of 2015, Mylan had an 85% market share of such devices in the U.S., and in that year sales reached around $1.5 billion and accounted for 40% of Mylan's profit. The price increase was met with widespread criticism of Manchin and Mylan. Manchin explained at the 2016 Forbes Healthcare Summit that Mylan's price increases were justified by the many improvements she claimed the company had made to the product. Amid this backlash, Manchin led Mylan to introduce a generic version of the device which sells for half the price of the brand-name device. The generic version in 2016 remained more expensive than the original brand version of EpiPen prior to Mylan's purchase of the rights, even when accounting for inflation.

In July 2019, Manchin announced that she would retire in 2020 after Mylan merged with Upjohn. The merger was completed in November 2020 and Manchin stepped down. The new company was named Viatris. According to the Pittsburgh Business Journal, when she left Mylan, she was the second most highly paid executive in the area of Pittsburgh, and received a "golden parachute" estimated at $30.8 million.

In 2021, a case was ongoing to determine whether Mylan had attempted to monopolize the EpiPen market, with both Mylan N.V. and Manchin being sued on racketeering claims and anti-trust claims. The lawsuit, which consolidated several consumer cases, was moved to federal court in Kansas City in 2017. In February 2020, the lawsuit moved ahead as a nationwide class action. On June 24, 2021, a federal judge tossed the racketeering claims and some of the antitrust claims, also dropping RICO claims against Manchin. The case went on trial on September 7, 2021. On September 7, 2021, Ryan Grim of The Intercept reported that during an ongoing racketeering case involving Mylan and Manchin, "newly released court documents show [Manchin] discussing a deal with Pfizer to eliminate a chief competitor to EpiPen, clearing the way for major price hikes." The 2010 and 2011 email discussions, unsealed by the judge, showed Manchin's assistant discussing divesting from Adrenaclick after the closure of the Pfizer/King deal. They "also show [Manchin] approving a scheme to force customers, captured by the company’s monopoly, to purchase two EpiPens at once, regardless of medical need."