Prescription-free Narcan could make medication too expensive, some warn
Naloxone has been used to reverse thousands of opioid overdoses in Massachusetts every year — on streets, in cars, in bedrooms and many other settings. This week the Food and Drug Administration said it will allow the makers of Narcan to sell the drug without a prescription. The FDA said the change will “address the dire public health need” and improve access.
In Massachusetts, many people working to reduce overdose deaths aren’t so sure.
“If Narcan is too expensive, then our fatality numbers could actually rise,” said Joanne Peterson, the founder and director of Learn to Cope, a statewide support network for families dealing with addiction.
Today, Narcan costs individuals about $150 for a two-dose package. The state pays just under $50 through a public interest discount. Narcan is already available to anyone in Massachusetts through a standing prescription the state sent pharmacies several years ago. And insurance covers most of the cost.
But if Narcan moves to the first aid aisle, individuals might have to pay the full price. Peterson said she’s already hearing lots of questions about whether the state will be able to continue distributing as many free kits — 132,690 last year. And she’s concerned that the 78,580 standing order purchases will no longer be affordable.
“That’s the main concern that I’m hearing,” Peterson said, “if insurance isn’t in the picture, how much is it going to be?”
A spokesman for Emergent, the company that makes Narcan, said it won't discuss price for now, but will work with the public agencies that rely on discounts. The transition from prescription to over-the-counter is not expected until late summer. Matt Hartwig, a spokesman for Emergent said that “the true cost will include the impact of what, if any, insurance coverage is provided.”
The state Department of Public Health is encouraging health insurers to continue coverage of naloxone once it is available over the counter, as they have for nicotine replacement products like patches. The major Massachusetts health insurers say they will review Narcan coverage plans in the coming months.
“As further regulatory guidance is released, we will assess coverage with a focus on protecting access to this critical emergency medication,” said Amy McHugh, spokeswoman for Blue Cross Blue Shield of Massachusetts, in a statement.
Narcan is one of the more well-known versions of naloxone. Other brands will continue to be sold with a prescription.
Many addiction treatment and outreach workers say the need for naloxone in whatever form is more urgent as fentanyl, the powerful painkiller that can stop breathing in seconds, is found in fake pills, cocaine, methamphetamine and other drugs where users don’t realize they are taking an opioid.
“I’ve used Narcan to reverse overdoses. I’ve talked to people who’ve saved multiple lives of their friends, of their children,” said Mary Wheeler, program director at the Healthy Streets Outreach program in Lynn. “Folks feel empowered saving a life, they don’t have to grieve a loss. It should just be another tool in our toolkit.”