Iowa Attorney General Settles on Narcan Rebate Agreement for First Responders

Iowa Attorney General Settles on Narcan Rebate Agreement for First Responders

News Oct 05, 2017

Oct. 05—CEDAR RAPIDS—As the demand for naloxone, a countermeasure to opioid-related overdoses that health officials say claimed 180 lives in Iowa last year, is increasing, the cost will drop as the result of an agreement the Iowa Attorney General's Office reached with a drugmaker.

The deal makes public agencies—law enforcement, emergency medical services and hospitals—eligible for a $6-per-dose rebate on naloxone purchases, Attorney General Tom Miller told a news conference Wednesday at the Cedar Rapids Fire Department Central Station.

"Quite literally, naloxone may be someone's only lifeline if they overdosed on prescription painkillers or heroin," Miller said. Naloxone revives a person experiencing an opioid overdose by quickly stopping and reversing its effects.

The two-year agreement with Amphastar Pharmaceuticals, a California drug manufacturer that supplies more than half of the naloxone dosages administered by Iowa first responders, makes the rebate available regardless of where the naloxone is bought.

The agreement came in response to the growing number of opioid-related overdoses and the cost that comes with administering naloxone.

"One of the situations we see as there is more demand for a drug... prices sometimes tend to skyrocket," Miller said. "While we're fortunate to have naloxone and it's so effective, we must also realize that making it available impacts budgets that fund Iowa's first responders and public health care providers."

The regular price for a dosage of naloxone runs from $23 to $48, Miller found. Cedar Rapids Fire Department Training Chief Andy Olesen said many of the first responders in the area buy naloxone through Mercy Medical Center to get the best possible price.

Miller said the rebate agreement "will provide some relief to public agencies that are pushed for public resources in so many ways. We also think it may be an indirect way to restrain increases in the future."

Negotiations have not been successful with all pharmaceutical companies, but Miller is continuing his efforts.

There are more than 900 EMS providers in Iowa. About 800 doses of naloxone have been administered across the state this year, according to data provided to Miller's office. Speakers at Miller's news conference offered various numbers, but agreed naloxone use is increasing.

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In Cedar Rapids, first responders administered 78 naloxone doses between March 1 and Oct. 1, according to Amy Kunkle, the department's EMS program director.

The regional EMS provider for Cedar Rapids and surrounding communities, Area Ambulance Service, reported administering naloxone to 102 people in 2016.

In Scott County, Linda Frederiksen of MEDIC EMS said administration of naloxone has gone from occasional to daily. So far, 450 doses have been administered this year and the county is on track to hit 600 before year's end. Her company alone has administered 306 doses to 215 people this year, she said.

Those numbers highlight a trend emergency medical service providers are reporting: the need for more than one dose of naloxone to treat someone who is overdosing. That's increasingly the case with people who use illicit opioids, which often are smuggled into this country, according to Dale Woolery of the Governor's Office of Drug Control Policy. Some agencies have doubled and tripled the number of naloxone injectors they carry, he said.

Nationally, the Centers for Disease Control and Prevention reported 33,091 people died of an opioid overdose in 2015, or about 91 people per day. Emergency rooms treated more than 1,000 people per day for misusing prescription opioids.

Data provided to Miller's office showed that several of the Iowa's larger EMS agencies report administering from dozens to hundreds of naloxone doses so far this year and last year.

A state law passed last year eased restrictions on the opioid antidote, enabling adults at risk of opioid-related overdose and their family and friends to purchase the drug from a pharmacy without a prescription.

Last month, Miller announced Iowa is part of a multistate investigation that seeks to determine whether opioid manufacturers and distributors engaged in unlawful practices in the marketing, sale and distribution of opioids.

The Gazette, Cedar Rapids, Iowa

James Lynch
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