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Price of Naloxone Skyrockets

Following the passage of legislation in many states to allow increased access to naloxone, the decades-old generic medication that can reverse the effects of some opioid overdoses and once cost little more than $1 per dose, has skyrocketed to more than $4,500 for a two-injector packet this year.

Earlier this year, the Medical Association assisted with the passage of legislation that significantly expanded access to naloxone to allow first responders to stock and carry naloxone in Alabama. The legislation also allows county health officers and the state health officer to specifically authorize broad-standing orders to increase access to the medication.

“Now that naloxone has been made more widely available to help save lives and curb Alabama’s prescription drug abuse and heroin death epidemic, the pharmaceutical companies that make this medication have taken the opportunity to over price this medication out of reach of those who need it,” said Medical Association Executive Director Mark Jackson. “It’s shameful that something that has been available for about $1 a dose for years is now so expensive that parents and communities simply can’t afford it. Naloxone has been proven to save lives, and the pharmaceutical companies that make it are taking that life-saving opportunity out of the hands of those who need it.”

The rising costs of prescription drugs have been a hot topic for physicians and lawmakers for some time, but with the spike in overdose deaths caused by prescription medications and street drugs, lawmakers are beginning to ask more questions of pharmaceutical manufacturers concerning the cost increases and why now.

In identical letters to five drug makers, U.S. Rep. Susan Collins and Sen. Claire McCaskill, who chairs the Senate Special Committee on Aging, wrote of their concern that rising prices “may be limited access for emergency responders and public health departments.” U.S. Sen. Bernie Sanders and Rep. Elijah Cummings followed by pressuring pharmaceutical company Amphastar for pricing information. Amphastar responded, in part, by striking deals with some states to sell its drug at a reduced rate.

However, in an economy driven by supply meeting demand, it would appear the pharmaceutical companies are unfortunately coming out on top, but at what cost? More than 28,000 people died from opioid and heroin overdoses in 2014, more than any year on record, according to the Centers for Disease Control.

The list price of Kaleo Pharma’s auto-inject version of naloxone — specifically approved for people without medical training to use — soared from $575 to $3,750 per two-dose package in just two years, according to Truven Health Analytics. Amphastar’s comparable product cost $66 for two syringes at the end of 2014, nearly double the price a year earlier. Two vials of Hospira’s generic, which cost $1.84 in 2005, shot up to $31.66 by 2014.

A third generic naloxone, Mylan, entered the market in 2014, but that didn’t reduce the drug’s price. Another new drug, Adapt Pharma’s Narcan nasal spray, was approved in November, at a list price of $125 for two doses, with a “public interest price” of $75 for first responders and certain others.

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