Surge in drug price won’t pose threat to heroin overdose patients in Washington

A dramatic price increase for one form of an opioid overdose reversal drug has some people concerned, but Washington health and law enforcement agencies said it’s not affecting their ability to provide care.

Last week, Washington Sen. Maria Cantwell joined 30 Democratic colleagues to sign a letter demanding answers from Kaleo Pharmaceuticals, which manufacturers an auto-injector form of naloxone. Naloxone is a generic drug that reverses opioid overdoses.

The drug has risen from $690 in 2014 to $4,500 this year, according to the letter. The drug manufacturer has disputed that price.

The letter prompted widespread coverage of the price boost in USA Today, Scientific American, Wired and other sources, with many articles comparing it to the well-publicized price hike of the Epi-Pen last year. But these articles largely gloss over the fact that other forms of naloxone are widely available, widely used and significantly more affordable.

Spokane firefighters carry naloxone and use it frequently, fire department medical director Mike Lopez said. They have intravenous, intramuscular and nasal spray forms available, all of which cost $29.39 per dose. That’s up from $5 to $10 per dose several years, ago, he said, which is “still a fairly dramatic increase in price.”

In 2016, firefighters used naloxone 371 times, making it their second most frequently used drug, Lopez said. Data from the Washington Department of Health shows 64 Spokane residents and 727 Washingtonians died from opioid overdoses in 2015.

Sacred Heart Medical Center also uses the drug, but most frequently in its intravenous form, spokeswoman Liz DeRuyter said. They have not been affected by the price increase.

In some states, laws designed to expand access to naloxone have required first responders to stock brand-name drugs, Wired reported, sometimes because of lobbying from Kaleo and other companies that manufacture it. But in Washington, Narcan, a cheaper brand-name nasal spray, and generic versions of naloxone, are more common.

The Spokane Regional Health District’s needle exchange program distributes naloxone that was made available through a pilot program with the University of Washington’s Alcohol and Drug Abuse Institute. The exchange has distributed a total of 189 kits to clients for free and documented 32 overdose reversals as a rule. It will likely will receive more as part of an ongoing federal grant for the ADAI.

ADAI program coordinator Susan Kingston said naloxone they distribute is in nasal spray form, which they get for $37.50 per dose. Even before the auto-injector price increase, purchasing such an expensive drug wasn’t on the table.

“The price is so prohibitive I don’t know of anyone who’s actually purchased it for agency use,” she said of the auto-injector. That price increase is just a dramatic example of the trend of pharmaceutical price increases across the board, she said.

Pullman police recently began carrying the nasal spray version of naloxone, which spokesman Commander Chris Tennant said cost $75 for two doses.

Multiple versions of naloxone also are available at pharmacies. CVS, which offers naloxone in Washington without an advance prescription from a doctor, sells nasal spray for $110 and a generic intramuscular injectable form of naloxone for $45, as well as the more expensive auto-injector, a spokeswoman said.