Price of life-saving drug naloxone rising

BY ERIKA NORTON
SPARTA — The price of naloxone, a prescription medication that can reverse the effects of an opioid overdose, is increasing dramatically, which has medical experts and lawmakers worried about community access to the life-saving drug.
The opioid and heroin epidemic is growing not only nationwide, but also in Sussex County. Last year, there were 52 overdoses in the county where naloxone was administered by law enforcement, according to the Sussex County Community Law Enforcement Addiction Recovery Program. This is up from 44 administrations in 2015.
Due to this growing need, a new study by a research team at Yale University and the Mayo Clinic is calling on on manufacturers to reduce the price of naloxone and increase transparency regarding their costs.
“When governments promote naloxone use, they have a responsibility to ensure the drug’s affordability,” the New England Journal of Medicine states. “Taking action now is essential to ensuring that this lifesaving drug is available to patients and communities.”
The costAccording to the study, while there are three manufacturers of naloxone with FDA approval, the vast majority are sold by Hospira, which has increased the price by 129 percent since 2012. Amphastar manufactures 1-mg-per-milliliter doses as an off-label a nasal spray, which currently costs $39.60 after a 95 percent increase in September 2014.
Newer, easier-to-use formulations are even more expensive, the study says. Narcan, the most common brand name and the formulation given out for free at the recent training session in Pike County, Pa., costs $150 for two nasal-spray doses.
A two-dose Evzio package, a patented auto-injector administered in the outer thigh, was priced at $690 in 2014 but is $4,500 today, a price increase of more than 500 percent in just over two years. It is the first auto-injector formulation designed to be simple to administer, allowing people without medical training to reverse opioid overdose, and it’s approval was fast-tracked by the FDA in 2014.
This naloxone price hike is part of a wave of prescription medication price increases, including Mylan’s EpiPen injectors for life-threatening allergic reactions and insulin for diabetes made by Eli Lilly and Company, Novo Nordisk and Sanofi U.S.
Det. Sgt. Terence Mulligan of Sparta police said that when the state of New Jersey first signed on and a bunch of departments started carrying naloxone, prices did shoot through the roof. But in 2014, he hooked up with a company out of Brooklyn to purchase naloxone from, and they’ve been great, he said.
“We’re probably paying top dollar,” Mulligan said. “They charge us for the atomizer, the liquid itself, which is in a mini jet, so they charge you separately. So, the atomizer and the jet itself, it’s probably about $20 a dose. We used six last year or nine total, so it’s definitely worth the money we pay.”
Mulligan said the Sussex County Prosecutor’s Office offers naloxone to police departments for free, but it’s easier for the Sparta department to just call this company and have it sent there within a couple days since there is money for it in the township budget. He said they purchase the formulation manufactured by Amphastar.
In Newton, Chief Michael Richards said he is aware of the price hikes, and that his department had seen significant cost increases shortly after New Jersey police departments began deploying the kits in their patrol cars. However, through working with the Sussex County Prosecutor’s Office, they have not been directly affected by the price increases.
“We have been fortunate to have a fantastic relationship with our local hospital, Newton Medical Center,” Richards said. “Newton Medical Center has donated numerous doses of Narcan which, in coordination with the County Prosecutor’s Office, have been distributed to Police Departments across Sussex County.”
Lawmakers’ responseWhile a number of federal and state initiatives have expanded the drugs availability, the research team urges lawmakers to address the drug’s rising cost. In response to the study, Sen. Cory Booker (D-N.J.) along with 31 other U.S. senators sent a letter Feb. 8 to Kaléo Pharmaceuticals, which manufactures the Evzio easy-to-use naloxone injection system.
The letter demands the manufacturer answer to why the price has increased, how the manufacturer’s donation program works and how many customers relied on federal funding to purchase Evzio.
“At a time when Congress has worked to expand access to naloxone products and to assist state and local communities to equip first responders with this life-saving drug, this startling price hike is very concerning,” the letter reads. “In response to press reports about the price increase, Kaléo has argued that the list price is not a ‘true gauge’ for what consumers are actually paying for the device, because through program discounts and coupons patients often have a low or even zero cost share for Evzio.
“We are concerned about the impact the high list price may have for those who do not qualify for the program and for state and local entities who hope to purchase large quantities of your product.”