Big Pharma Company Jacks Up Price of Overdose Life Saver by 1100%: Now, More People Will Die

They don't seem to mind importing cocaine and heroin.....
 

Naloxone is key to fighting overdose deaths, but sky-high prices threaten community distribution programs.

Tessie Castillo
Alternet

A remarkable thing happened in 2008: drug overdose surpassed auto fatalities as the leading cause of accidental death in the United States. Public health officials declared an epidemic, and communities united to battle this new enemy that had left a staggering body count in its wake. The people had a weapon, naloxone, an antidote that reverses opiate overdose, and programs began popping up across the country to provide training and free naloxone to people at risk for overdose. But then Big Pharma stepped in. The same year that naloxone became so critical to saving lives, one pharmaceutical company secured a monopoly on its production and jacked up the prices by 1,100%.

The company, Hospira, claims its monopoly on injectable naloxone was unintentional. Naloxone has enjoyed price competition from manufacturers since it first came on the market in the 1960s, but in the early 2000s manufacturers began closing production lines without explanation. Hospira became the sole producer of injectable naloxone by default – a position it still holds today as no new manufacturers have stepped into the market. Generic, sterile injectables like naloxone can be difficult and costly to produce, and low return on investment is likely a deterrent to new manufacturers.

Whether Hospira maintains its grip on naloxone due to natural market forces or deliberate attempts to monopolize a product of increasing value to our over-prescribed nation, the price increases have been detrimental to overdose prevention programs. When costs blew up in 2008, threatening the sustainability of one of the largest naloxone distribution centers in the country, the Chicago Recovery Alliance, director Dan Bigg called Hospira to plead for a price break.

“One of Hospira’s marketing executives explained the rationale behind the increase,” says Bigg. “He told me that Hospira wanted to increase the average customer bill by 3-4%. Instead of raising all their prices and risk losing customers to the competition, they combed through their list of products and chose one item for a price increase so high as to cause the average bill to go up 3-4%.”

That product was naloxone.

In hindsight, naloxone was an obvious pick. Almost every doctor’s office and hospital across the country stocks naloxone. It is the only antidote for a growing public health crisis. And, of course, Hospira is the sole manufacturer, leaving customers no choice but to absorb the price increases if they want access to this life-saving medication.

Bigg has been lucky, as he was able to broker a deal with Hospira to buy naloxone at a reduced price, and he says Hospira is open to working with nonprofits to make naloxone more affordable. Unfortunately, other community programs may be too small to bargain for price breaks or don’t have a medical provider on staff who can order directly from a pharmaceutical company. According to Bigg, the bulk of naloxone customers -- hospitals and doctors' offices -- aren’t complaining about the price hikes. Naloxone makes up such a tiny portion of their budgets, they might not even notice the extra cost. So, as with many things, the heaviest burden falls on those who can least afford it – small, community distribution programs that depend on inexpensive naloxone to keep saving lives. And these programs are closing.

Naloxone distribution programs are critical to overdose prevention; since 1996 they have handed out more than 53,000 naloxone kits and report over 10,000 overdose reversals. That’s 10,000 lives potentially saved -- one for every five kits distributed. A 2013 study on the effectiveness of naloxone distribution programs in Massachusetts reported a 27-46% reduction in overdose deaths in towns with a distribution center, even when adjusting for other factors. But according to Eliza Wheeler, member of a research team at the Harm Reduction Coalition that produced a report on naloxone distribution programs published by the CDC, in the past two years alone, almost 10% of the distribution programs have closed their doors. And when naloxone centers disappear, the remarkable declines in overdose deaths start to bounce back up.

With a powerful monopoly maintaining a tight grip on naloxone prices, the situation might look grim for small community programs. In addition to price increases, naloxone supply has also suffered from quality control problems in the manufacturing system and periodic shortages. However, there are practical solutions available if the government, the pharmaceutical industry and community advocates intervene.

One solution that could increase supply and reduce prices is for the Food and Drug Administration to allow temporary importation of naloxone from foreign manufacturers. According to Open Society Foundation’s research on global naloxone supply, in many countries naloxone is produced for under $2 a dose. There is also precedent for the government to allow importation in times of crisis. However, some advocates are pessimistic.

Whitney Englander, government relations manager with the Harm Reduction Coalition in Washington D.C., is involved in national advocacy around naloxone access issues and has moderated phone calls between the FDA and the community. “There is a precedent for the U.S. to allow temporary importation of foreign medications in the case of shortages,” explains Englander, “but we [Americans] are fiercely protective of our pharmaceutical industry. On our calls [with the FDA] it doesn’t seem that they are even considering that possibility right now.”

Besides importation, the federal government can lower prices by enticing new pharmaceutical companies to enter the market through a fast-track approval process. The FDA can also approve naloxone for over-the-counter use so that people who need it can purchase directly from pharmacies, and the government can create a stockpile of affordable naloxone for emergency use.

Hospira also has a responsibility to ensure access to naloxone. The company could arrange price deals with nonprofits, as it has with the Chicago Recovery Alliance, or even donate naloxone to community organizations that distribute it to needy populations. Based on numbers from a confidential industry source, Nabarun Dasgupta, an epidemiologist at the University of North Carolina, estimates it would cost a mere $100,000 for Hospira to supply every harm reduction program in the country with enough naloxone to meet current capacity.

“I call Hospira an irresponsible monopoly,” Dasgupta says. “Naloxone is a $20-million-a-year industry; they can afford compassionate pricing for nonprofits.”

continued: http://www.alternet.org/big-pharma-...4JwZ&rd=1&src=newsletter821675&t=5&paging=off

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Well there is a bright side to this story for american junkies , say they OD and are brought to a hospital ; now there is a difference between the dose of naloxone needed to remove the life threatening effect of excessive respiratory depression and the dose needed to put said junky in full withdrawal, maybe hospitals/doctors will start noticing that difference once they feel it in their pockets. (note never OD'ed and subsequently been "Narcanized" in the states but guess it's the same as over here)
 
Okami;11478533 said:
Anyway that article claims that the U.S. doesn't allow imports of foreign produced drugs, is that true? Can't seem to find a definitive answer using google.

They do allow for the importation of foreign produced pharmaceuticals on a case-by-case basis in a few situations- particularly shortages in US produced pharmaceuticals. The FDA has said that they do not think that the current situation warrants allowing importation of naloxone and thus not granted an allowance for importing.
 
mds275;11479223 said:
They do allow for the importation of foreign produced pharmaceuticals on a case-by-case basis in a few situations- particularly shortages in US produced pharmaceuticals. The FDA has said that they do not think that the current situation warrants allowing importation of naloxone and thus not granted an allowance for importing.

Can you link me to a source of any kind that also mentions the USA's policy to not import foreign produced pharmaceutics. I don't doubt its true I would just like to know details before I start using it as an example of the US is only in favour of the free market if it helps big business make money.
 
We import foreign drugs all right. But only one drug maker is licensed to sell naloxone in the US.
 
Can you link me to a source of any kind that also mentions the USA's policy to not import foreign produced pharmaceutics. I don't doubt its true I would just like to know details before I start using it as an example of the US is only in favour of the free market if it helps big business make money.
The FDA does allow for importation under certain conditions. Here's a US FDA summary and this is the actual text of the law (2003), if you want to make your eyes cross.

But only one drug maker is licensed to sell naloxone in the US.
The article is incorrect- there are actually two manufacturers of naloxone in the US- Hospira and IMS/Amphastar.

do we allow naloxone sourcing here? I haven't been keeping up.
I'm under the impression that naloxone sourcing is OK because of the incredible lifesaving potential- I do it all the time! Please advise if I am wrong...I'd hate to break the rules ;)
 
less junkies = better........ any kind of lifeform where fit ones drag the burden of unfit is doomed to exctinction...
 
I was gonna say... Patent on such an old drug? Sounds pretty absurd. Not sure about the structure and how it's synthed, but opiates are genereally pretty expensive it seems. From what I hear, a lot of 3rd world nations have an extreme shortage.

Now what is worse lol?!
 
Big deal, so someone is making more money. All the more power to them.

CRA still gives out free naloxone, hospitals won't run out of it anytime soon, and now police officers are beginning to carry it.
 
DOB;11482046 said:
less junkies = better........ any kind of lifeform where fit ones drag the burden of unfit is doomed to exctinction...

Junkies will always be around. Even in countries where a small amount of drugs will get you killed by the government, junkies are around. Given that, a productive junkie is a hell of a lot more useful than one without access to their DOC.
 
My exchange in town (they're partnered with CRA) still gives out free nalxone amps. Maybe someone will come up with a very short half life partial agonist (think weak/short acting bupe) to grab a new monopoly or another kind of short acting antagonist.
 
Big deal, so someone is making more money. All the more power to them.

CRA still gives out free naloxone, hospitals won't run out of it anytime soon, and now police officers are beginning to carry it.

This is the big deal: CRA (Chicago Recovery Alliance) the first naloxone project in the US has shut down program sites and they spend nearly every waking hour figuring out where to get enough $$ to buy naloxone. For ex, fundraising last International Overdose Awareness Day and selling t-shirts to buy naloxone. Make no mistake- these prices, if they hit CRA, will definitively end that program.
 
Has shut down programs sites... Means what exactly? There schedule looks pretty much the same as it did when i used them 12-15 years ago. They don't give out free naloxone anymore? Or has nothing has changed as of now?

Well if that is the case I am sure they will find a way to get donations, a grant, or make a side deal with the manufacturer. The article doesn't mention what happened when the director pleaded for a reduction. Maybe they should try to pass the costs on to the consumer. What kind of price increase are you talking about? Definitely won't be the end of the naloxone program, where there is a will there is a way.
 
bagochina;11482750 said:
Big deal, so someone is making more money. All the more power to them.

I'm sorry what? You're cheering on a multibillion dollar company when they pull a dick move to make even more money? That money could be used in hundreds of other beneficial ways including rehab programmes to stop the need to buy as much naloxone in the first place.

Fuck me I'm never going to move to America, you make British conservatives look like Mother Teresa.

mds275;11481890 said:
The FDA does allow for importation under certain conditions. Here's a US FDA summary and this is the actual text of the law (2003), if you want to make your eyes cross.

Thank you
 
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