For people with severe allergies, having an EpiPen handy can mean the difference between life and death. So why did Mylan, the pharmaceutical company that bought the epinephrine-injecting device in 2007 recently raise its price by almost 400 percent? A new report by Forbes uncovers the motives behind the pharmaceutical industry’s latest price controversy.

The EpiPen is an auto-injector device that administers carefully calibrated dosages of epinephrine, or adrenaline hormone, into the body. Epinephrine is most often used for the treatment of anaphylaxis, a serious allergic reaction that can cause itchy rashes, swelling of the tongue or throat, shortness of breath, low blood pressure and sometimes death. Currently, the FDA recommends that people with severe allergies have at least one EpiPen on hand at all times. But today, in the United States, the devices cost $500 or more, and many patients say they’re having a hard time affording the effective and easy-to-use emergency allergy relief product.

The EpiPen wasn’t always so expensive. In fact, the device cost only $57 per shot in 2007, before Mylan acquired it, and around $100 in 2008. Advocates for patients argue that the company’s careful branding and aggressive marketing of the drug’s delivery system have significantly driven up the cost of an EpiPen during the last nine years. The price soared even higher once Mylan achieved a virtual monopoly on the EpiPen’s technology after the company’s main competitor recalled its own epinephrine-injecting device early last year.

Another epinephrine injector on the market, called Adrenaclick, costs around $142 after using a coupon. In addition, it’s also possible to use a syringe to administer epinephrine during an allergic reaction. But doctors warn that these methods don’t offer any dosing protections and patients must be careful not to inject the medication into a vein rather than a muscle as indicated, which can be fatal. In response to criticism of its price point for the device, Mylan pointed to the company’s offer of free EpiPens to uninsured patients who apply on their website and its “$0 co-pay cards” for the back-to-school season. Still, for most patients with high health insurance deductibles, the cards don’t result in any savings.

“It’s almost like companies are tryna make money and s---,” tweeted Turing Pharmaceuticals CEO Martin Shkreli, the subject of his own pharma company’s pricing scandal earlier this year. “[This] should be illegal.”

Whether he was being serious is anyone’s guess as Shkreli doesn’t advertise the fact that he’s bested Mylan’s 400 percent price increase for EpiPens when his company raised the price of an HIV and malaria drug by nearly 5,000 percent.

For more information on Shkreli’s big health care blunder, click here.