The 400 per cent spike in the price of EpiPen devices for those with severe allergies in the U.S. has sparked outrage among American doctors and politicians.

Epinephrine auto-injectors such as EpiPen are used as an emergency treatment by people who have a history of serious allergic reactions, called anaphylaxis, or who are at risk because of allergies to foods, insect bites and stings or medicines.

In the U.S., Mylan Pharmaceuticals has increased the price of its EpiPen injectors up to three times a year over nearly a decade, pushing the cost to more than $600 US for a pack of two.

White House spokesman Josh Earnest wouldn't comment directly on Mylan's pricing of EpiPens.

"I'm obviously not going to make specific comments to specifically second guess the pricing strategy … of one private enterprise," Earnest said at a news briefing.

EpiPens can be the difference between life and death. There's no justification for these price hikes. <a href="https://t.co/O6RbVR6Qim">https://t.co/O6RbVR6Qim</a> -H —@HillaryClinton



"I will observe, however, that pharmaceutical companies that often try to portray themselves as the inventors of life-saving medication often do real damage to their reputation by being greedy and jacking up prices." "I will observe, however, that pharmaceutical companies that often try to portray themselves as the inventors of life-saving medication often do real damage to their reputation by being greedy and jacking up prices."

Earlier today, the American Medical Association and U.S. Democratic presidential nominee Hillary Clinton urged Mylan to rein in what the AMA called the "exorbitant cost" of EpiPens.

"Although the product is unchanged since 2009, the cost has skyrocketed by more than 400 per cent during that period," AMA president Dr. Andrew Gurman said in a release.

"The AMA has long urged the pharmaceutical industry to exercise reasonable restraint in drug pricing, and, with lives on the line, we urge the manufacturer to do all it can to rein in these exorbitant costs."

If someone experiences anaphylactic shock, symptoms can include wheezing, hives and skin swelling to rapid heartbeat, trouble breathing and convulsions. Without treatment, it can be deadly.

No price change in Canada

Pfizer Canada distributes EpiPens through a license from Mylan, which owns the brand.

A spokesperson for Pfizer Canada said the price has not changed and there are no plans to do so.

In Canada, drug prices are regulated by the Patent Medicine Prices Review Board.

"We can confirm that, at this time, there are no investigations or hearings ongoing with respect to EpiPen," a spokesperson for the board said in an email.

In an emergency, the syringe is jabbed against the thigh. The needle inside injects the epinephrine into muscle tissue.

Back-to-school season is a good time to check the expiry dates on epinephrine injectors, said Beatrice Povolo, director of advocacy and media relations for Food Allergy Canada. Schools often ask students with severe allergies to bring an auto-injector to school and sometimes ask for a back-up device to deliver the life-saving medication.

The devices last about 12 to 18 months.

With 8% margins, Mylan is close to breaking even. Do we want them to lose $? Sole supplier of a life-saving drug should have a better margin —@MartinShkreli

"We feel that everyone should have access to life-saving medication and that cost shouldn't be a barrier. Thankfully we're not seeing the same issues here as we are in the U.S.," Povolo said in an interview.

In the U.S. in 2007, when Mylan took over rights to EpiPen, a pair of syringes cost $93.88 US. The price of a pack of two is now about $600 US, according to Elsevier's Gold Standard Drug Database.

In a previous statement, Mylan said the EpiPen's price "has changed over time to better reflect important product features and the value the product provides."