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Samantha Liss, quoting Rachel E. Sachs (Academic Fellow Alumna)
St. Louis Post-Dispatch
September 4, 2016

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From the article:

[...] Usually, insurance carriers decide if the update is meaningful. If the update is minimal and there are other competitors, usually the insurance carrier favors the other product.

But the EpiPen created the perfect storm for this issue because there are no competitors.

“This is a really important issue,” said Rachel Sachs, a law professor at Washington University, who specializes in patent law and drug regulation.

“This is a very common tactic: to apply for a patent on a slightly modified version of the drug or device in order to extend your monopoly,” Sachs said. [...]

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