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In a setback to Mylan Pharmaceuticals, the Ohio House of Representatives on Wednesday unanimously approved a bill that would allow pharmacists to substitute alternatives for the pricey EpiPen allergic-reaction device without requiring a new prescription from a physician.

The bill must still pass a Senate vote, but it has the potential for altering the competitive landscape, since pharmacists in these states are currently prohibited from unilaterally making any substitutions for the device. Similar legislation has been introduced in four other states — New York, New Jersey, Hawaii, and Vermont — but have not progressed this far.

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