Keri Blakinger | October 15, 2015
Even as the death toll increases during a recent heroin epidemic, manufacturers are raising the price of naloxone, a drug that can reverse overdoses.
In one formulation, the cost of the drug has increased nearly 50%, while in another it’s gone up by more than 75% — just in the past year.
The newer formulation of naloxone is Amphastar’s intranasal spray. Though the product is not actually approved for use as a nose spray, it comes in a concentration that makes that use possible.
According to the city’s Department of Health and Mental Hygiene, the cost for a two-pack of the spray has gone up from $50 to $70 in the past year.
Matt Curtis — the policy director of Vocal-NY, a Brooklyn harm reduction center that distributes both intramuscular and intranasal naloxone — said that he’s also seen sizable price increases in Hospira’s injectable version of the drug.
“It went from a little less than $20-a-pop…up to $36 a dose,” he told the Daily News.
He also said this isn’t the first time there’s been a sizable cost hike.
“Before the last round of increases that started last fall with Amphastar, we had seen the price of the intramuscular go up,” Curtis said.
“The intranasal had been steady at $18 to $22 per dose, where the intramuscular formulation by Hospira increased by like 1,100% over the course of a few years and was really starting to become problematic,” he said.
Because of distributor pricing variations and existing purchasing agreements, the cost of naloxone can vary depending on the purchaser and the region.
Curtis said that some entities get better prices because they have agreements that allow them to buy directly from the manufacturer, but others are forced to buy from distributors.
“The drug companies set their wholesale price and then the distributor marks it up,” he said. “That’s why you see a fair amount of variation around the country, at the distributor level.”
Although the spate of police departments and state agencies purchasing naloxone kits has put it in the news recently, the drug has been around since the early 1960s. For many years, its use was mainly limited to emergency care providers.
Curtis said that the first community distribution programs began in the mid-1990s in Chicago. Now, some schools and many police departments carry it and harm reduction centers — like Vocal-NY — are able to distribute kits to users after a quick training process.
However, the drug’s increased availability has coincided with price hikes.
“Naloxone has been off patent for decades,” Julie Netherland, the deputy state director for the Drug Policy Alliance’s New York office, told the Daily News.
“We know that it’s cheap to produce and we know that the prices have been going up steadily right at the time that we’re having a major overdose epidemic and crisis,” she said.
The city’s health department reports that the opioid overdose death rate in New York City has increased by 41% since 2010.
Curtis said that the increase in prices seems tied to demand. Last year, after the state announced plans to spend $5 million equipping law enforcement with naloxone kits, Amphastar raised its prices.
“It was within 6 or 8 weeks…they hiked the price by about 100%,” he said.
Part of the reason that companies are able to roll out such significant price hikes is that there’s almost no competition.
“This has happened with a lot of older generic drugs that are off patent,” Harm Reduction Coalition Policy Director Daniel Raymond told The News. “There used to be four or five manufacturers but because they didn’t have the same profit margin as name brand drugs, the competitors decided to drop out of the market.”
Amphastar did not respond to a request for comment, while Hospira offered a limited response.
“Hospira’s injectable naloxone, in its most common clinical presentation, is about the cost to feed a family of four a fast-food meal, priced significantly below the cost of many other life-saving drugs on the market today,” Hospira communications manager Julie Ferguson said.