Gov't urged to invoke authority to boost OD antidote access
The Trump administration should invoke government authority to slash prices of a life-saving overdose drug or provide funding to expand access amid the coast-to-coast opioid epidemic, Baltimore's health department and a national advocacy group said Thursday.
America is in the throes of its worst-ever drug crisis, yet the generic medication available in other countries by the pennies remains pricey enough in the U.S. that Baltimore's health agency is rationing its naloxone supplies. Other hard-hit U.S. municipalities are also feeling the squeeze as rising overdose rates are fueled by synthetic opioids.
It's galling to public health experts as there's no national shortage of naloxone, an "opioid antagonist" which restores a person's breathing after it's sprayed in the nostrils or delivered via an auto-injector.
"What's short is our willpower to do something about it," said Baltimore Health Commissioner Dr. Leana Wen, who issued an innovative blanket prescription for naloxone in 2015.
On Thursday, Wen and the Public Citizen nonprofit made their appeal for government intervention in a letter to Kellyanne Conway, a Trump counselor who is leading much of the White House's work on opioids. They say they received no immediate response.
The U.S. Department of Health & Human Services did not respond directly when asked about the concept of invoking government authority to circumvent manufacturer patents on naloxone. Instead, a spokeswoman said the agency has several funding streams to expand local access, and that authorities are working to ensure there's "adequate competition" for naloxone, which she said would lead to lower pricing.
Narcan—a brand name for the FDA-approved naloxone inhalers—costs $125 per two-dose carton wholesale. First responders and community organizations can purchase Narcan at group discounts of $75 per kit of two doses, according to manufacturer Adapt Pharma. The auto-injector has wholesale prices of some $3,800 for a box with two doses.
The Virginia-based Kaleo pharmaceutical company, which makes the Evzio auto-injector, has recently announced an initiative allowing federal and state government agencies to make direct purchases of two-pack kits for $360 each. On Thursday, it noted it has also donated more than 30,000 of its auto-injectors to the Baltimore health department since 2014.
But at a press conference in Washington with Public Citizen officials and others, Wen said her department should not have to depend on the generosity of drugmakers "in order to fund something that is a lifesaving mandate for us."
The appeal for government intervention comes as growing anecdotal evidence suggests that multiple naloxone doses are needed to reverse an overdose caused by synthetic opioids like fentanyl, more than the single dose it takes to reverse a heroin overdose.
Last month, U.S. Surgeon General Dr. Jerome Adams issued the office's first national public health advisory in 13 years, calling on more Americans to start carrying naloxone and urging more federal funds to be dedicated to increasing antidote access on local levels.
Wen is pressing for urgent action: "Either the federal government can offer naloxone at a much discounted rate, at a rate that's proportional to the severity of the disease, or we can get a lot more funding for naloxone. Either way. For us, it's all about saving the lives of fellow residents."
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