The Adrenaclick, which can be found for as little as $140 with the right discount coupon, according to Consumer Reports, is not on a lot of insurance formularies. And perhaps in part because of that, physicians don't write prescriptions for it. They prescribe the EpiPen. Thanks to strict rules about substitution, if pharmacists get a piece of paper telling them to dispense an EpiPen, they cannot say: “Very good, Moddom. Would you like our top-of-the-line, gold-plated epinephrine-dispensing device, or would you like to take a look at some of our lower-priced offerings?” They have to give you an EpiPen. With no generics available, well, enjoy your $600 device that will only last a year before the drug inside degrades and you have to replace it.
These artificial barriers to entry are why we keep seeing huge price spikes for various drugs.
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