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Making Opioid Overdose Antidote Affordable Would Save Lives

Worst Pills, Best Pills Newsletter article July, 2018

On April 5, U.S. Surgeon General Jerome Adams issued an advisory urging more Americans to carry naloxone (EVZIO, NARCAN), a lifesaving medication used to rapidly reverse opioid overdoses.[1] Naloxone, which is available in an easy-to-use auto-injector[2] and a nasal spray[3], routinely is carried by many first responders, such as paramedics and police. The Surgeon General recommended that more individuals, including those at risk of opioid overdoses and their family and friends, keep the...

On April 5, U.S. Surgeon General Jerome Adams issued an advisory urging more Americans to carry naloxone (EVZIO, NARCAN), a lifesaving medication used to rapidly reverse opioid overdoses.[1] Naloxone, which is available in an easy-to-use auto-injector[2] and a nasal spray[3], routinely is carried by many first responders, such as paramedics and police. The Surgeon General recommended that more individuals, including those at risk of opioid overdoses and their family and friends, keep the drug on hand.

The Surgeon General’s advisory comes at a time when the rate of opioid overdose deaths is rapidly rising. Although the advisory was a welcome development, unaffordable prices are a major hurdle to providing easy-to-use naloxone products to all households throughout the U.S. that should have immediate access to them.

The drug naloxone itself is available in generic form and can be purchased from suppliers in India for as little as 15 cents per dose.[4] However, Narcan — the nasal spray version of naloxone — is under patent until 2035.[5] Until then, only one company — Adapt Pharma — can make it, which gives that corporation monopoly power. Narcan has a list price of $75 per dose and is available at half this price to public providers, such as city and county health departments.[6] Similarly, Evzio — the only naloxone auto-injector product marketed in the U.S. — is under patent until 2034.[7] The list price for Evzio is more than $4,000, and it is newly available to public providers at $180 per dose.[8]

Even with the public-provider discounts, local governments still lack the resources to obtain sufficient quantities of naloxone for all citizens who need it.[9] As a result, city and county health departments are forced to ration this lifesaving antidote.

On May 3, Public Citizen and the Baltimore City Health Department petitioned the Trump Administration to use a rarely invoked authority to lower the price of the easy-touse naloxone products.[10] Under “government use authority,” the U.S. government can procure generic versions of on-patent drugs from other manufacturers. If the Trump administration invoked this authority, state and local agencies could act as agents of the federal government and buy generic versions of Narcan and Evzio directly from these manufacturers at markedly reduced prices. The federal government also could buy generic versions of these products and supply them to local health and law enforcement programs.

As Robert Weissman, president of Public Citizen, succinctly stated on May 3, the choice is simple: the Trump administration “can choose to lower prices and save lives. Or they can choose to perpetuate the rationing of lifesaving treatments and avoid offending Big Pharma.”[11]

References

[1] HHS.gov. Surgeon General releases advisory on naloxone, an opioid overdose-reversing drug. April 5, 2018. https://www.hhs.gov/about/news/2018/04/05/surgeon-general-releases-advisory-on-naloxone-an-opioid-overdose-reversing-drug.html. Accessed May 16, 2018.

[2] Kaleo, Inc. Label: naloxone injection (EVZIO). October 2016. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/209862lbl.pdf. Accessed May 16, 2018.

[3] Adapt Pharma. Label: naloxone nasal spray (NARCAN). January 2017. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/208411s001lbl.pdf. Accessed May 16, 2018.

[4] Public Citizen. Trump administration should use rarely invoked authority to expand access to opioid overdose antidote. May 3, 2018. https://www.citizen.org/media/press-releases/trump-administration-should-use-rarely-invoked-authority-expand-access-opioid. Accessed May 16, 2018.

[5] Ibid.

[6] Public Citizen. Trump administration should use rarely invoked authority to expand access to opioid overdose antidote: Full statements from speakers at the Baltimore press conference. May 3, 2018. https://www.citizen.org/media/press-releases/trump-administration-should-use-rarely-invoked-authority-expand-access-opioid-0#Hopkins. Accessed May 16, 2018.

[7] Public Citizen. Trump administration should use rarely invoked authority to expand access to opioid overdose antidote. May 3, 2018. https://www.citizen.org/media/press-releases/trump-administration-should-use-rarely-invoked-authority-expand-access-opioid. Accessed May 16, 2018.

[8] Public Citizen. Trump administration should use rarely invoked authority to expand access to opioid overdose antidote: Full statements from speakers at the Baltimore press conference. May 3, 2018. https://www.citizen.org/media/press-releases/trump-administration-should-use-rarely-invoked-authority-expand-access-opioid-0#Hopkins. Accessed May 16, 2018.

[9] Ibid.

[10] Public Citizen. Trump administration should use rarely invoked authority to expand access to opioid overdose antidote. May 3, 2018. https://www.citizen.org/media/press-releases/trump-administration-should-use-rarely-invoked-authority-expand-access-opioid. Accessed May 16, 2018.

[11] Public Citizen. Trump administration should use rarely invoked authority to expand access to opioid overdose antidote: Full statements from speakers at the Baltimore press conference. May 3, 2018. https://www.citizen.org/media/press-releases/trump-administration-should-use-rarely-invoked-authority-expand-access-opioid-0#Hopkins. Accessed May 16, 2018.