Naloxone.
It's the only thing standing in between first responders and the opioid overdose epidemic in South Florida.
And now prices for the drug, which is used in the commonly known spray called Narcan, are skyrocketing according to The New England Journal of Medicine. Authors compare the reported price increase of naloxone to the Epi-Pen hike.
Naloxone reverses the affects of a heroin and other opioid overdoses. It's something our newsteam has covered in ride alongs with local agencies.
There have been 47 opioid deaths so far this year and that's just in Delray Beach, so the price hikes are presenting a new type of emergency for the agencies who use the antidote.
Justin Greenberg works on the frontline of the opioid epidemic at Reliance Treatment Center.
"I spend the most time with the clients," he said. "I've seen what good it's done because I've seen the success and recovery of someone who needed Narcan that saved their lives and the amazing life that they live today."
He says the reported price hikes on naloxone jeopardize the work it takes to save lives.
"How do you put a price on saving a life? That's my first thought that comes to mind," he said.
Naloxone's been on the market since the 1970s but more potent opoids like fentanyl are pushing an increase in demand for the live-saving antidote and that is making it harder to keep up.
The drug is available in nasal spray called Narcan and injection and auto-injection form called Evzio.
The injection, sold by a manufacturer kaléo Pharma, cost $690 in 2014. The current price has shot up to $4,500, according to The New England Journal of Medicine.
First responders use naloxone more than anyone else.
"It's the antidote that's going to save their life," said Capt. Curtis Jepsen of Delray Beach Fire & Rescue.
Capt. Jepsen says he sees dozens of cases in just one day. The department's EMS crews administer both the nasal and injection form of the antidote.
"We've given up to 10 milligrams which would be the equivalent of five doses to one patient," he said.
Too often, Jepsen says their crews have to give several doses to help overdose victims start breathing again.
"Ten to 20 overdoses a day on some of the really really busy days and we give 2 or 3 doses on those," he said.
That means up to 20 to 30 doses a day. And it's taking a hit on their department's budget.
According to Delray Beach Fire and Rescue spokesperson, Kevin Saxon -- in 2015, Delray's Fire and Rescue Department spent about $8,300 on naloxone drugs. In 2016, it nearly tripled $28,000. For 2017, they've already spent $23,000 on the antidote to prepare for next year's wave.
Mark Herzog, VP of Corporate Affairs for kaléo Pharma -- which manufactures Evzio -- responded to our inquiries for comment.
"Drug pricing is a complex issue that involves multiple stakeholders, including insurers, payers and pharmacies. In order to fully understand drug pricing and its challenges for naloxone and other pharmaceutical products in the U.S., it's necessary to look at all aspects and parties involved," he told WPTV. "As a company founded by patients for patients, we are concerned about the number of lives lost each day to the opioid overdose crisis and the inability of patients to access EVZIO due to insurance coverage restrictions and high out-of-pocket costs.
Herzog said they have a plan in place to address the issue.
"We have enhanced patient access program so all patients and caregivers with commercial insurance and a prescription can obtain EVZIO for $0, whether or not their insurance that patients, physicians or pharmacists can use to get immediate assistance and access that $0 copay program. We are proud to report that the new patient access program is working," he said in the statement.
Herzog also said kaléo also has programs in place to ensure that those without insurance are able to access EVZIO for free.
"The company also has donated more than 150,000 EVZIO Auto-Injectors to over 250 first responder agencies, public health departments and non-profit community groups across 34 states. Based on voluntary reports from kaléo's donation program grantees, more than 2,000 lives have been saved with the help of EVZIO, or an average of 20 lives per week since October 2014," Herzog said.
Mike Kelly, President of US Operations for Adapt Pharma, which manufactures Narcan nasal spray, issued a similar statement to WPTV, saying that they have worked to prevent a price increase on Narcan.
"Not all naloxone products are the same and comparing them as such may be misleading," Kelly said. "Transparency on price and affordability are cornerstones of our approach to maximize access."
Kelley sent the following price breakdown that Adapt Pharma has implemented to help address the demand for the naloxone drug:
- For those with insurance, 94% of insured lives in the US have coverage for Narcan Nasal Spray. According to IMS Health, nearly three quarters (74%) of retail prescriptions for Narcan have a co-pay of $10 or less.
- For those paying cash, Adapt Pharma has partnered with retail pharmacies to reduce out of pocket costs. For example CVS offer a $35 discount to anyone paying cash.
- For Qualified Public Entities (departments of health, police, firemen, community groups) purchasing for local use/distribution, Adapt has implemented price of $37.50 per device or $75 per carton of two doses.
