The rising price of naloxone -- risks to efforts to stem overdose deaths

A nationwide campaign is underway to widen access to naloxone, with initiatives taking shape at the federal, state, and local levels. The escalating cost of the drug, however, could hamstring these efforts.

A nationwide campaign is underway to widen access to naloxone, with initiatives taking shape at the federal, state, and local levels. The escalating cost of the drug, however, could hamstring these efforts. Naloxone is available in three different formulations—in two injectable doses, previously used off-label for nasal delivery; as the brand nasal spray Narcan; and through an auto-injector—each of which essentially has a single supplier. As the sole manufacturer of the injectables, Amphastar hiked the price of its product 95% about 2 years ago and now charges $36.90; while Hospira has increased the price of its 0.4-mg-per-milliliter-dose injections by 129% since 2012 and two doses of Adapt's Narcan cost $150. The cost of a two-pack of Kaleo's Evzio auto-injector, meanwhile, has catapulted more than 500% from $690 for two doses in 2014 to $4,500 currently. Government must take a stand and ensure that naloxone remains affordable, experts from Yale University and the Mayo Clinic write in a perspective published in the New England Journal of Medicine. It could intervene, they suggest, by purchasing naloxone in bulk, a tactic that has worked with vaccines; by sanctioning the import of generics from international sources; or by making naloxone available as an OTC product, among other strategies.