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Monday, August 01, 2016

A nice little racket

by Tom Sullivan

Pfizer Japan headquarters, Tokyo
Public domain via Wikimedia Commons.

The Centers for Disease Control estimated in 2014 that 47,055 people in the U.S. died of drug overdoses, a record high (no pun intended). Sixty percent were from opioids.

At a small breakfast a few months back, our local sheriff explained that opioid overdose deaths had become such a problem that deputies were having to carry antidotes in their cars. Affording doing that has become a problem in itself:

Frequently referred to as an "antidote" for opioid overdoses, naloxone has seen drastic price increases in recent years, according to information provided by Truven Health Analytics, a healthcare-analytics company. A popular injectable version of the drug has gone from $0.92 a dose to more than $15 a dose over the last decade. An auto-injector version is up to more than $2,000 a dose.

On the market since 1971, naloxone works by blocking opioid drugs from interacting with the brain's receptors, counteracting the drugs' dangerous side effects, like slow respiration, coma, and death, during an overdose. The drug almost instantly pulls an overdose victim back to sobriety and has only minor side effects for opioid users — and almost none if mistakenly administered to patients not suffering an overdose.
In a June press release, Sen. Claire McCaskill's (D-Missouri) office said:
A recent Politico article, however, noted that the price of at least one version of naloxone reportedly rose 17-fold in the last two years. In addition, a Healthline article indicated that hospitals have reported difficulty obtaining sufficient quantities of the drug.

In response to these reports, Senators Collins and McCaskill wrote to the five companies that manufacture naloxone to provide insight into “what actions [they] are taking to ensure continued and improved access to naloxone, an explanation for price changes in [their] company’s naloxone product, and a description of the available resources and tools to prevent barriers to access and shortages of this critical and life-saving medication.”

The five companies the Senators have requested information from include: Amphaster Pharmaceuticals, Inc.; Pfizer, Inc.; Adapt Pharmaceuticals; Kaléo Pharma; and Mylan Inc.
Business Insider has a long piece explaining why a medicine "as cheap as sterile sodium chloride" has risen so high, and what the companies say about that:
Bigg and Castillo [representatives of harm-reduction organizations] said that their organizations, which provide naloxone to those in need for free, would not be able to exist without such generosity on the part of pharmaceutical companies. According to Bigg, many police departments have money to pay for naloxone because of asset seizures, which confiscate the alleged proceeds or instruments related to crime. Many federal, state, and local government agencies have also been given grants to pay for naloxone.

While these measures have generally increased the availability of naloxone, Castillo says the result is that those hardest hit by the high prices are smaller harm-reduction organizations or community programs that don't have the clout of larger government agencies or the renown of a large nonprofit like the Harm Reduction Coalition. Castillo says that she has spoken to "lots and lots" of organizations and programs that have closed in recent years or failed to get started because of naloxone's high price tag.
Anybody else see a vicious cycle here, where opioid pain-killers made by Big Pharma produce overdoses, creating demand for antidote drugs made by Big Pharma, driving up the price for the antidote, to where police have to use asset seizures to raise money to buy Big Pharma's antidotes for Big Pharma's drugs?