Narcan nasal spray maker aims for over-the-counter price of less than $50

By Katherine Dillinger, CNN

Emergent, the maker of the opioid overdose antidote Narcan, said in a statement Thursday that it is aiming for an out-of-pocket price of less than $50 for its nasal spray product now that the US Food and Drug Administration allows for over-the-counter sales.

Public interest groups such as government agencies, nonprofits and first responders pay less than $50, on average, for a kit of two 4-milligram doses, the company says. The wholesale price is $125 per kit. “A goal for the out-of-pocket retailer price is to be consistent with our public interest pricing … although retail price is set by individual retailers.”

In an April 6 letter to Emergent, Sen. Richard Blumenthal of Connecticut asked the company to respond by Thursday with “the affordable OTC Narcan list price that your company intends to set.”

“Currently, your product is reported as having a wholesale price as high as $120 for two doses, with significant variation in price depending on location and insurance coverage. Individuals without insurance — about one fifth of people with opioid use disorder are uninsured — will be forced to bear the full cost. Even individuals with insurance and low co-pays can struggle to afford Narcan,” he wrote. “I ask you to commit to work with public health experts, addiction specialists, and community activists to develop and determine a list price for OTC Narcan that makes it affordable and accessible for those who need it most.”

In a response letter Thursday, Emergent emphasized the importance of continued federal funding for substance abuse treatment and prevention programs, including opioid response initiatives that distribute Narcan, and for private insurers, Medicare and Medicaid to consider their coverage of the medication.

Emergent aims to have Narcan available online and in stores by late summer.

Harm-reduction experts have said the price of naloxone, the overdose antidote medication in Narcan, has inhibited its accessibility for people who need it most and will probably still be out of reach for many, despite a potential price drop with OTC availability.

Dr. Rahul Gupta, director of the White House’s Office of National Drug Control Policy, said when the FDA approved OTC naloxone last month that the administration is asking Emergent to keep the price low.

“We’ve got to make sure that these life-saving medications, as well as treatment, is accessible across no matter where you live, rural or urban, rich or poor,” he said.

Narcan works by blocking the effects of opioids on the brain and restoring breathing. For the most effectiveness, it must be given as soon as signs of overdose appear.

The drug works on someone only if there are opioids in their system. It won’t work on any other type of drug overdose, but it won’t have adverse effects if given to someone who hasn’t taken opioids.

Each kit contains two doses in case the person overdosing does not respond to the first dose. However, Emergent says most overdoses can be reversed with a single dose. The product can be administered to anyone, even children and babies.

More than a million people have died of drug overdoses in the two decades since the US Centers for Disease Control and Prevention began collecting that data. Many of those deaths were due to opioids. Deaths from opioid overdoses rose more than 17% in just one year, from about 69,000 in 2020 to about 81,020 in 2021, the CDC found.

Opioid deaths are the leading cause of accidental death in the US. Most are among adults, but children are also dying, largely after ingesting synthetic opioids such as fentanyl. Between 1999 and 2016, nearly 9,000 children and adolescents died of opioid poisoning, with the highest annual rates among adolescents 15 to 19, the CDC says.

About 1.2 million doses of naloxone were dispensed by retail pharmacies in 2021, according to data published by the American Medical Association — nearly nine times more than were dispensed five years earlier.

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CNN’s Nadia Kounang, Jen Christensen and Deidre McPhillips contributed to this report.