Viewpoint: Big Pharma didn't drive up the cost of naloxone, 'opportunity has'

With the increase of illicit drug use and overdoses, the emergency response drug naloxone should be made available over the counter, write Michael Hufford, PhD, co-founder and CEO of Harm Reduction Therapeutics and Donald Burke, MD, dean of Pittsburgh-based Graduate School of Public Health at the University of Pittsburgh,  in an op-ed published by STAT.

Here are four things to know:

1. In the op-ed, Dr. Hufford and Dr. Burke compare the prices of heroin and the opioid overdose antidote naloxone. In the 1980s  1 gram of heroin cost about $2,200. In 2018 1 gram would cost less than $500, they write.

2. Naloxone's cost in the early 2000s was about $1.00. In 2018, the same dosage costs about $150 in its nasal spray form and $4,500 in its auto-injector form.

"Pharmaceutical innovation hasn’t driven up these prices. Opportunity has," they write.

3. The authors indicate street drugs are more affordable and available while naloxone is more expensive and hard to get.  

"Its high price and restricted availability — despite its low production costs and excellent safety and effectiveness records — betray our collective ambivalence about the millions of Americans with opioid use disorder," they write.

4. Dr. Hufford and Dr. Burke propose making naloxone over the counter, in large amounts and at lower prices. In 1971 the FDA approved naloxone for prescription use and could easily elevate it to over the counter status. Nonprofits could eliminate the naloxone markup and produce a generic brand. ScottGottlieb, MD, commissioner of the FDA will hold a meeting in December to discuss how to improve naloxone products.

"The pharmacoeconomics of the opioid epidemic are not on our side. But let us hope that common sense is. In a sane world, naloxone should be at least as available and affordable as heroin," they write.

More articles on opioids: 

4 ways opioids affect children in different states
Michigan patients only take 27% of prescribed opioids
BCBS of Alabama to drop coverage for OxyContin

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