[maxerickson]

I don't think it is a massive regulatory failure to have the pharmacy dispense a product with matching use instructions to the product that is prescribed.

So it's the market that has doctors prescribing $600 Epipens instead of the $150 alternative (that has different use instructions and thus cannot be used to fill a prescription for an Epipen).

[gwright]

Isn't this just another example of a problem created by the rules/regulations? A pharmacist is forbidden from providing the $150 alternative even if the customer specifically requests it (because of the prescription requirement and rules).

For those who need epinephrine injectors, can't they just ask their doctors to prescribe Adrenaclick? What prevents that from happening? I'm guessing it is insurance guidelines that are also stuck in the EpiPen-only world but perhaps it is also doctors being too conservative?

[maxerickson]

It's marketing. I saw some discussion on social media, people expressed a preference for the Epipen because they expected other people to be more aware of how to use it.

Same with parents, they expect the school nurse to be more familiar with the Epipen (and I guess the other way around, the nurses prefer Epipen because they are familiar with it).

If asking the pharmacist for a specific type of injector isn't onerous then neither is asking the doctor.

I'm willing to concede that US medical regulation has lots of problems, but there is also clearly some problems with the way people in this market are behaving. Patients should care about saving $1000-$1500. Doctors should care about saving their patients $1000-1500.

[gwright]

Well in a perverse sort of way, the $600 price tag is certainly one way to motivate patients to demand alternatives from their doctors and insurance companies.