I must admit that my reply was narrow-focused on Mylan not being able to pin the costs on compliance. After a re-read of your original comment, I see exactly th

I must admit that my reply was narrow-focused on Mylan not being able to pin the costs on compliance. After a re-read of your original comment, I see exactly the point you're making. You're right. The reason Mylan jacked the price up isn't directly due to their costs of compliance, it's related to the industry's cost (that is, any potential competitor), and the competition that is stifled because of it. Your point about handling the injections the old fashioned way is a good one as well. But it's worth noting that diabetics have tons of experience self-injecting using standard needles and vials. A typical Epipen user has probably never had to do so, and when the drug is urgently needed is a bad time to get started. So for these users it's not simply a matter of convenience.