Drug mak­ers prof­i­teer from the opi­oid cri­sis

USA TODAY US Edition - - NEWS -

Al­most like magic, the drug nalox­one can bring vic­tims of opi­oid over­doses back from the brink of death. With more than 115 peo­ple dy­ing each day from opi­oid over­doses across the coun­try, the drug could save thou­sands of lives each year.

Ex­cept for one prob­lem.

The prices of nalox­one set by phar­ma­ceu­ti­cal com­pa­nies have sky­rock­eted, putting it be­yond the reach of some po­lice, first re­spon­ders, com­mu­nity groups, and fam­i­lies and friends of over­dose vic­tims.

Though the drug has been around in generic form for more than 30 years — which ought to make it cheap — the price for one in­jectable form more than tripled since 2012. Another, ac­cord­ing to a study set to be pub­lished in the jour­nal Ad­dic­tive Be­hav­iors, rose 244% since 2006.

Nalox­one is not a cure for ad­dic­tion, but much like a de­fib­ril­la­tor for heart at­tack vic­tims, it re­vives peo­ple so they can live long enough to get treat­ment.

While price goug­ing in the drug in­dus­try has spurred ma­jor scan­dals, un­til re­cently nalox­one’s price hikes weren’t get­ting much at­ten­tion. That’s chang­ing.

Sen­a­tors have de­manded answers from sev­eral man­u­fac­tur­ers. Re­searchers in publi­ca­tions such as the New Eng­land Jour­nal of Medicine have dis­sected the price hikes. And Pres­i­dent Trump’s com­mis­sion on the opi­oid cri­sis re­ported last year that lack of af­ford­abil­ity was pre­vent­ing state and lo­cal gov­ern­ments and com­mu­nity groups “from stock­ing nalox­one at the lev­els nec­es­sary to res­cue more peo­ple.”

In other words, peo­ple are dy­ing un­nec­es­sar­ily.

Many of those who see the car­nage on the streets were dis­ap­pointed last week when Trump an­nounced a plan to lower pre­scrip­tion drug prices but failed to even men­tion nalox­one.

Con­sumer ad­vo­cacy or­ga­ni­za­tion Pub­lic Cit­i­zen and Bal­ti­more’s health com­mis­sioner, Leana Wen, wrote to the White House ask­ing the ad­min­is­tra­tion to use ex­ist­ing laws to rein in the price of nalox­one, adding that high prices are forc­ing her to “ra­tion treat­ment, con­stantly stretch­ing sup­plies that could be dis­trib­uted in a week across months.”

West Vir­ginia Health Com­mis­sioner Rahul Gupta says the state’s vol­un­teer fire de­part­ments are par­tic­u­larly stressed. He cites as an ex­am­ple the as­tro­nom­i­cal price of an auto-in­jec­tor called Evzio, which drug maker Kaléo says came on the mar­ket in 2014 at $575 for a pack of two and is now $4,100. (Kaléo’s CEO told Sen. Susan Collins, RMaine, in 2016 that a pre­vi­ous hike made its “pa­tient ac­cess pro­gram” pos­si­ble.)

Even a generic in­jectable form of nalox­one made by Hospira, pur­chased by drug gi­ant Pfizer in 2015, more than tripled, from about $3.75 per dose in 2012 to $11.87 per dose now. Only Nar­can, a nalox­one nasal spray, has not in­creased in price since its 2016 in­tro­duc­tion at $150 per two-pack. But even Nar­can’s dis­count price of $75 is too steep for many gov­ern­ments.

It’s not as though these com­pa­nies are risk­ing bil­lions of dol­lars to in­vent a new drug. They’re sim­ply de­vel­op­ing dif­fer­ent de­liv­ery mech­a­nisms for an ex­ist­ing, in­ex­pen­sive one.

Man­u­fac­tur­ers in­sist that “list prices” are mean­ing­less be­cause of all the dis­counts they of­fer. Pfizer adds that it has not raised the price of nalox­one since ac­quir­ing Hospira. But the ac­tual prices paid by con­sumers for pre­scrip­tion drugs are vir­tu­ally in­de­ci­pher­able be­cause of all those dis­counts, coupons and “pa­tient ac­cess pro­grams.”

Fur­ther con­fus­ing the sit­u­a­tion is a gag­gle of terms such as the “whole­sale ac­cess price” (WAC) and the “av­er­age whole­sale price” (AWP), which one ex­pert jok­ingly called the “ain’t what’s paid” price. Com­plex­ity makes it eas­ier to hide un­scrupu­lous be­hav­ior.

Two things are clear: Prices of most nalox­one prod­ucts have in­creased, some­times dras­ti­cally, as more peo­ple are dy­ing from over­doses of pre­scrip­tion painkillers and other opi­oids. And some­one is pick­ing up the tab, in­clud­ing tax­pay­ers who foot the bills for gov­ern­ment pur­chases.

Drug mak­ers helped cause the opi­oid epi­demic by mis­rep­re­sent­ing the risks of ad­dic­tion. It’s un­con­scionable that other drug mak­ers are prof­i­teer­ing from the cri­sis when so many lives are at stake.

MEL EVANS/AP

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