Opioid antidote Narcan will cost $45 at major U.S. drugstore chains this fall
Narcan, the lifesaving opioid overdose antidote, will cost about $45 for two doses when the first over-the-counter version hits drugstore shelves at Walgreens, CVS Health and other chains in the next few weeks.
Manufacturer Emergent BioSolutions has begun shipping the nasal spray to pharmacies, grocery stores and online retailers, according to a statement Wednesday. It will be available for consumers to purchase at thousands of U.S. pharmacies as soon as early September, and companies plan to make it easy to find at pharmacy counters and checkout registers.
“Narcan should be a medicine cabinet staple that is in all homes and first aid kits so that individuals are prepared to act in the case of an opioid emergency,” according to a spokesperson for Rite Aid, which will charge almost $46 for the drug.
More than 100,000 Americans died of drug overdoses in 2021, according to the Centers for Disease Control and Prevention. The age-adjusted annual death rate jumped 14% in 2021, fueled by a surge in illicit fentanyl. Its deadliness has been increased by frequent combination with xylazine, a potent animal sedative that doesn’t respond to overdose reversal drugs.
Narcan’s cost is key because most health insurers don’t cover it without a prescription. Brand-name, prescription Narcan can cost upward of $130 for two doses, but that’s often covered by insurance. Advocates have said that a price of less than $50 for the nonprescription item would still be too expensive.
“It’s exploitation of a community that has already been exploited for decades,” said Jose Martinez, a coordinator at the nonprofit National Harm Reduction Coalition that focuses on overdose prevention and drug policy. “It is scary to know there is now going to be a market that thrives the more our community is impacted.”
Medicare Part D plans that pay some of seniors’ outpatient drug costs usually don’t cover over-the-counter medications, including those based on naloxone, Narcan’s active ingredient. Medicare Advantage plans, the private versions of the government program, can choose to cover Narcan without a prescription as a supplemental benefit.
The Centers for Medicare and Medicaid Services is encouraging states to offer Medicaid coverage for over-the-counter Narcan. Health plans sold on the insurance marketplace aren’t required to cover the drug either, but they can choose to do so, CMS said.
Walgreens is exploring additional partnerships that will allow for better pricing, a spokesperson said. Emergent says it will lower the price to $41 for public interest groups, like community organizations and first responders.
An over-the-counter nasal spray was likely to be an expensive option, compared with an injectable, said Maya Doe-Simkins, co-director of Remedy Alliance, a nonprofit distributor of low-cost overdose-reversal medications. The device itself is more expensive than the dose of naloxone it contains, she said.
“It is too expensive,” she said in an interview. The product is unlikely “to fly off pharmacy shelves and certainly not at gas-station shelves.”
Nonprescription Narcan was approved in March, and followed by the approval of another naloxone-based spray called RiVive in July. “We also hope the FDA’s approval of over-the-counter naloxone will lead to more naloxone products in the marketplace to help ensure affordable access for customers,” a spokesperson for CVS said.
The nonprescription product will be available at all pharmacy locations nationwide, Walgreens said, and it’s working with a nonprofit called End Overdose to educate the public on how to use it. Rite Aid said it will be stocked in its pain-care aisle and pharmacy counter. CVS said customers will have the option of having Narcan delivered, giving additional privacy.