Rising cost of naloxone worries advocates
Just as officials across the country are agreeing that it makes sense to hand out an easy-to-administer heroin-overdose antidote to police, families of addicts and drug users themselves, those buying it face a new obstacle. The price of one popular form has doubled in the past year.
The rising cost of naloxone, often sold in the U.S. under the brand name Narcan, has some officials scrambling to negotiate discounts and has curtailed access in some places. No one is believed to have died because higher prices made the remedy unavailable, but advocates fear that could be the ultimate cost.
“If you have a fire extinguisher that costs several hundred dollars, some people are going to go without — and some are going to get burned,” said Daniel Wolfe, director of the international harm-reduction program at the Open Society Foundations.
JSAS HealthCare, a clinic based on the New Jersey shore, began last year training community members to administer the drug and providing it to them with the help of state funds.
But a price increase late last year means that instead of buying 400 naloxone kits for a little under $21,000 — at $51.50 per kit paid to a third-party distribution company — that’s now enough for only 200, at just under $100 per kit, a negotiated discount that’s $5 cheaper than what he was quoted.
Three companies market naloxone in the U.S., including a relatively low-cost injectable version and a new Epi-Pen-style device that goes for hundreds of dollars per dose.
The most-popular version among police and many other groups — one that can be converted into a nasal spray, sold by Amphastar Pharmaceuticals Inc., of Rancho Cucamonga, Calif. — is twice as expensive as a year ago.
“Like other companies in the industry, manufacturing costs for our entire portfolio of products, including naloxone, have been steadily increasing due to the continued rise in costs for raw materials, energy and labor over the recent several years,” company president Jason Shandell said in an email.
In some countries, naloxone costs less than $1 per dose, Wolfe said, noting that a lack of competition could be contributing to a higher price here.
JSAS limits how many people get naloxone at some training seminars in hopes that the clinic will have enough to distribute until more funding is available in July, executive director Ed Higgins said.
Naloxone reverses the effects of opioids — drugs derived from opium, including heroin — on brain receptors. Advocates say it has no major side effects other than opioid-withdrawal symptoms and does not create a high.
For Project DAWN in Cuyahoga County, a Cleveland program that distributes naloxone, last fall’s price increase derailed a plan to hand out about 4,000 kits this year. Instead, the program scaled back to 2,100, said Dr. Joan Papp, medical director. With rebates announced last week by Ohio’s attorney general, the program can purchase another 800 to 900 kits.
The increases have been a concern for poorer communities, particularly in southeastern Ohio, said Andrea Boxill, deputy director of Gov. John Kasich’s Cabinet Opiate Action Team. Kasich has included $1 million in his two-year budget proposal to help communities buy naloxone.