Naloxone’s High Price Could Put It Out of Reach for Some First Responders

In the last few years, dozens of states have passed good Samaritan laws that prevent prosecution of addicts or bystanders who use the drug naloxone (also known by its brand name Narcan) to reverse an opioid overdose. But now a new problem surrounding Narcan has emerged; as more police departments stock the drug to be used in emergencies, the lone company that makes the version at the dose that can reverse overdoses has raised the price so much that some officials fear they will no longer be able to buy it.

Naloxone was found to be effective decades ago in bringing surgical patients out of anesthesia, and then later to reverse opioid overdoses. The drug is typically given as an injection, but that can be a slow process so many police departments have added an atomizer that allows officers to spray the drug into an addict’s nose. In the last year, however, many communities have seen steep increases in the cost of naloxone. In Baltimore, for example, the price went from $20 per dose in February to $40 a dose in July, according to reporting by National Public Radio.

Maryland Rep. Elijah Cummings (D) received responses to his query about increasing prices of the drug and was told by its maker, Amphastar Pharmaceuticals, that manufacturing costs are increasing. Several states including New York and Connecticut have been able to negotiate per-dose rebates for the drug. Daniel Raymond, a program officer with the Harm Reduction Coalition, a drug abuse policy program based in Washington, D.C., says he thinks the company won’t negotiate a lower price for the entire U.S. because the federal Centers for Disease Control and Prevention is expected to release guidelines in 2016 on treating opioid abuse and naloxone could be more widely covered by insurers than it is now. “Negotiating the price down now would get them less reimbursement if and when wider use is recommended,” Raymond said.

Raymond says access to naloxone could increase once the guidelines are issued by having insurers cover it, having community organizations make the drug widely available and by making it available at pharmacies without a prescription (but only from a pharmacist), and paid for with funds from insurers, community organizations and pharmacies. Two companies have submitted applications to the Food and Drug Administration for approval for nasal spray versions of naloxone. However, the companies won’t be discussing the price of the drug until their versions are approved by the FDA.

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