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>I will also note that the cost of the EpiPen is not due to the drug.

Spot-on. I remember when I was doing my anesthesiology residency and I asked the guy who ordered drugs for our department what a 1cc vial or ampoule of epinephrine (an auto-injector delivers precisely that amount) costs; he replied (this was the late 1970s, mind you), "About 10 cents." Even allowing for inflation, I can't imagine it's more than $1/dose today.

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Looks like king county is getting them for $9/dose:

https://www.jems.com/articles/print/volume-42/issue-6/featur...

I talked with a Pharmacist a few months ago about the cost of epinepherine, and a 10 dose bottle was $6.

I must say I'm surprised this drug is available in a multidose bottle because of the potential for contamination. I've only ever seen it — in many hospitals large and small, in both California and Virginia, over the past 40 years — in 1cc bottles and ampoules. That is and has long been the default adult SQ and IM dose. In STAT situations it's given IV or, as a last ditch measure attempting to reverse cardiac arrest, via direct intracardiac injection using a long needle.

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