A temperature-stable naloxone and intramuscular delivery device that makes an inadvertent needle stick virtually impossible has been developed. Recently, this device, called Evzio, received FDA approval.
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ACEP Now: Vol 34 – No 01– January 2015According to representatives of Kaléo, which makes Evzio, pricing has not been fully worked out, and there will likely be volume and institutional discounts. However, according to a New York Times article, the cost could be in the hundreds of dollars for each device.4
Sustainability
Lastly, how are first responders going to get reimbursed for medication replacement? They do not typically bill insurers or patients, and regardless, many of these patients do not have any coverage or the ability to pay.
Best Practices
With all advances come potential difficulties. Naloxone administration has the potential to save many lives. It is important to realize the potential unintended consequences so that first responders develop a program that is safe to the patient and provider, effective, and sustainable.
Dr. Kivela is managing partner at Napa Valley Emergency Medical Group, medical director of Medic Ambulance, and part owner of Elan Medical Corporation. He is Vice President of the ACEP Board of Directors.
References
- Ogbur O. Naloxone–hydrochloride injection (Narcan, Evzio). MedicineNet. Available at http://www.medicinenet.com/naloxone-injection/article.htm. Accessed Jan. 5, 2015.
- World Health Organization. Accelerated stability studies of widely used pharmaceutical substances under simulated tropical conditions. Available at http://apps.who.int/medicinedocs/es/d/Jh1808e. Accessed Jan. 5, 2015.
- Naloxone. PDR Network. Available at http://www.pdr.net/drug-summary/naloxone-hydrochloride?druglabelid=777. Accessed Jan. 5, 2015.
- Rosenthal E. For drugs that save lives, a steep cost. The New York Times. April 27, 2014. SR4.
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One Response to “Naloxone to Reduce Opiate Overdose Deaths Raises Cost, Liability, and Safety Concerns”
February 8, 2015
Larry Bedard, MDAn excellent analysis by Dr. Kivela. From a cost benefit ratio it is clear that the benefit of the increased availability and use of Narcan far, far exceeds the cost of training and equipping forst responders. An opportunity for emergency physicians to provide leadership on the local and state level in addressing the opiate overdose epidemic.