JUST ANOTHER CONSUMER GOOD:

The Adrenaclick, which can be found for as little as $140 with the right discount coupon, according to Consumer Reports, is not on a lot of insurance formularies. And perhaps in part because of that, physicians don't write prescriptions for it. They prescribe the EpiPen. Thanks to strict rules about substitution, if pharmacists get a piece of paper telling them to dispense an EpiPen, they cannot say: "Very good, Moddom. Would you like our top-of-the-line, gold-plated epinephrine-dispensing device, or would you like to take a look at some of our lower-priced offerings?" They have to give you an EpiPen. With no generics available, well, enjoy your $600 device that will only last a year before the drug inside degrades and you have to replace it.

These artificial barriers to entry are why we keep seeing huge price spikes for various drugs. Now, it's worth noting that these spikes don't necessarily last very long. With the exception of some new, expensive and very valuable drugs, such as Opdivo for cancer or Sovaldi for Hepatitis C -- drugs for which there isn't a good alternative -- competition eventually becomes a problem for price-hiking drugmakers. Patients and doctors will eventually switch to another product if the price gets too high, and I'm sure that in the wake of all these news stories, there are now a lot more doctors asking patients whether they want an EpiPen or an Adrenaclick. Eventually, that competition should push the price down even if the government doesn't do anything.

But if you're a patient who's looking at paying $600 for an EpiPen that you need to save your life, that's probably not very comforting. You want a solution now.

Is Hillary Clinton's solution the right one? Sort of. I tend to think that it overcomplicates things. Our health care system already has too many overlapping panels of bureaucrats trying to tweak the market. And I don't favor either of the two simple, obvious solutions that I've seen proposed -- a price-control board, or allowing re-importation of U.S. drugs from Europe (which is basically just re-importing European price controls) -- because the relatively free pricing of the U.S. market provides the profits that support pharmaceutical R&D. Which has given us great, valuable drugs like Sovaldi and Opdivo.

What I do favor is the economist Alex Tabarrok's proposal for drug reciprocity with Europe: If a drug or device may be sold there, then it should be approved for the U.S. as well. We don't need to import their price controls, or impose ones of our own. We just need to import their competition. (Europe has many epinephrine pens on the market).

Beyond that, we should have a good long think about what the FDA does. A lot of the reason that it can be so hard to get new drugs and devices approved is that the FDA too often wants those drugs and devices to be perfect -- at least as good as anything already on the market and preferably better. And it does not really consider factors such as "It's cheaper," or "It will keep the other companies honest" when passing judgment.

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