Even when/if generics come onto market, it’ll be tough to dislodge the existing pen purely due to brand recognition. At this point, Epipen is like Band-Aid — patients actually use the specific brand name to refer to the general product class.

The only way to gain ground would be to offer the generic at a really low price and that would kill a lot the value proposition for a competitor coming into the market (especially if potential entrants have to invest in manufacturing technology).

Basically, unless the companies with products already on market pay the generic companies not to come into the market (which is something that does happen in the pharma world), we should see generic entrants at some point. That said, it’s unlikely that those companies will let prices plunge to rock bottom in order to retain some ability to earn a decent return.

Unfortunately, US pricing tends to subsidize prices in the rest of the world. If companies can’t earn in the US, then chances are that the global value proposition for most products would be out the window.