Huh! So we had an affordable solution all around but it was illegal ?
Marketing and consumer behavior contributed to people not seeking out the cheaper option.
Classic case of the government causing abusive artificially high prices for consumers through bad regulation.
A prescription written for Epipen still can't be filled with generic Adrenaclick, so "was illegal" isn't a great description of that situation. It's hardly complicated to ask a doctor to write a different prescription, so that's why I talked about consumer behavior and marketing. Given that the different mechanisms require different training, I am somewhat forgiving of the "as written" requirement for auto-injectors.
The government's position might be considered overly cautious but I agree with it in this case, the two injectors are sufficiently different that they're not drop-in replacements for each other.
Evaluating the distinction doesn't require anything close to an advanced degree but it's not legal for anyone who isn't credentialed to vend/dispense/trade/exchange/grant/supply/provide the still-very-effective, much cheaper alternative based solely on the customer's informed demand--doing so would be "illegal".
Yes, if your highly-trained, well-payed, in-demand pharmacist has the time and interest; they can work through the call tree until he reaches your highly-trained, well-payed, in-demand doctor; who would've wrote a more general prescription in the first place if it didn't increase their chances of being sued, and get the prescription changed. The problem is, apparently, that hasn't happened often enough--probably because it doesn't happen for free. Someone ends up paying for it e.g., the doctor and pharmacologist, other patients, the insurer and their other clientele or the tax payer--multiplied times however many epinephrine injectors are sold in a given year.
There are few incentives to economize in the chain of payers because health-care is an unlimited 'right' that should be provided for by someone (everyone) else: https://en.wikipedia.org/wiki/Tragedy_of_the_commons
* Link from above: https://www.youtube.com/watch?v=LRgqwgCh4Fs
The government certified highly trained doctor seems to have simply overlooked that a cheaper and almost as good alternative existed!
By volume, it was mostly insurance or non person entities (school systems and the like, by gov mandate) that paid for it. Of course when insurance pays everyone pays through their premiums, but that's where the consumer behavior comes in, who cares what it costs if it is covered.