Study finds cost of naloxone may prevent patients from receiving it


A new study from researchers with Harvard University has found that while treatment guidelines recommend co-prescribing naloxone to patients at high risk of opioid overdose, few patients actually get naloxone because of its price.

The study looked at the rates of and costs of prescribing naloxone to high risk patients. Using insurance claims data from January 2014 to December 2018, the group was able to identify patients at high risk for overdose. Those high risk patients were diagnosed with opioid use disorder, had overdosed, had an opioid prescription of higher than 50 mg equivalents per day, or had a concurrent benzodiazepine prescription.

Of the more than 616,000 in the group who were determined to be high risk, only about 3,100, or 0.5 percent, were dispensed naloxone.

Researchers concluded that the total out of pocket expense of the drug for the patient ranged from $31 for naloxone to $135 for Evzio. The out-of-pocket cost for the opioid averaged around $13.

“Patient paid copays had out-of-pocket costs for naloxone that were nearly triple the amount for the index opioid prescription that identified the patient as high risk,” the study said. “Access to naloxone has improved in recent years through the widespread implementation of standing orders and collaborative practice agreements. Other efforts such as opioid education and naloxone distribution programs have helped distribute naloxone across the US. Despite these access-focused initiatives, cost remains an important issue for many patients who obtain naloxone from their pharmacies.”

The study found that the package price for Ezvio was $4,920 while the cost of Narcan was $150, both containing two doses.

Generic alternatives could bring the price down, the study found, but until there was widespread competition, the prices would remain high. Study authors also recommended that insurance companies could lower the co-pay on the drug to reduce costs to high risk patients.