Surgeon General: More people should carry naloxone
- Surgeon General Jerome Adams on Thursday called for more Americans to carry naloxone, a medication that can reverse the effects of an opioid overdose.
- The recommendation comes shortly after the Centers for Disease Control and Prevention released data showing emergency department visits due to suspected opioid overdoses spiked 30% between July 2016 and September 2017. More than 42,000 died from overdoses in 2016, according to government figures.
- Next Wednesday both chambers of Congress will hold hearings on competing legislative packages aimed at stemming the opioid crisis. Both the House and the Senate are considering allowing the government to place limits on opioid prescriptions for acute pain.
The American Medical Association strongly endorsed the advisory, citing its recommendation that physicians co-prescribe naloxone for all patients at risk of overdosing on opioids.
"All forms of naloxone should be readily available and covered by insurance plans with minimal or no cost-sharing. The AMA looks forward to working closely with the Surgeon General’s Office to help bring an end to the epidemic of opioid overdose deaths,” Patrice Harris, chair of the AMA opioid task force, said in a statement.
The surgeon general cited research that naxolone access saves lives.
“To manage opioid addiction and prevent future overdoses, increased naloxone availability must occur in conjunction with expanded access to evidence-based treatment for opioid use disorder,” the surgeon general said.
But not everyone thinks naxolone is a magic cure.
One recent study by researchers at the University of Virginia and University of Wisconsin–Madison called into question the wisdom of expanding access to naloxone, finding that increasing access led to more opioid-related ED visits and theft without reducing mortality. The study also found suggestive evidence that broadening naloxone access increased fentanyl use.
That paper, however, came under fire from many policy experts who criticized the study design.
Several drugmakers make injectable version of naxolone.
One of those, Kaléo, announced two initiatives in conjunction with the surgeon general's announcement.
The company launched a pilot program in six states to allow those with commercial insurance to obtain its auto-injector EVZIO from a pharmacist without a prescription and have it delivered to their home. Separately, the company announced a direct purchase price of $180 per auto injector for federal and state governments that but it directly from Kaléo. The list price for their drug is $4,100 for a two-pack, according to a company spokesperson.
While large employer coverage spending on opioid prescriptions hit a high in 2009, spending on treating opioid addiction and overdoses has spiked in recent years. Among the same population, spending on treatment hit $2.6 billion in 2016 compared to $300 million 12 years earlier, according to the Kaiser Family Foundation.
The House Energy & Commerce Health Subcommittee is set to hold the last of three hearings on its opioid legislation April 11, with a goal of bringing a package to the House floor before the Memorial Day recess. The Senate HELP Committee Wednesday released a bipartisan discussion draft of its own opioid package, and is set to also hold a hearing on April 11.
Both the House and the Senate are considering allowing the government to place limits on opioid prescriptions for acute pain.
- Surgeon General Surgeon General’s Advisory on Naloxone and Opioid Overdose
- SSRN The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime
- U.S. Senate HELP Committee The Opioid Crisis Response Act of 2018
- U.S. House of Representatives Committee Repository Hearing: Combating the Opioid Crisis: Improving the Ability of Medicare and Medicaid to Provide Care for Patients
- Peterson-Kaiser Health System Tracker A look at how the opioid crisis has affected people with employer coverage
- Healthcare Dive Legislation looks to limit length of opioid prescriptions
- STAT Senators ask drug makers to explain prices for opioid overdose antidote
Follow David Lim on Twitter