The Surgeon General Wants More Naloxone, Now What?

April 16, 2018
Christine Blank
Christine Blank

Christine Blank is a contributing editor.

What do pharmacies have to do with the recent Surgeon General Advisory? A lot, actually.

CVS announced expanded access to naloxone after US Surgeon General Jerome M. Adams, MD, MPH, urged more Americans to carry naloxone to reverse opioid overdoses.

“For patients currently taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids, individuals using illicit opioids such as heroin or fentanyl, health care practitioners, family and friends of people who have an opioid use disorder, and community members who come into contact with people at risk for opioid overdose, knowing how to use naloxone and keeping it within reach can save a life,” Adams said in an advisory.

Related article: Four Ways Pharmacists Are Fighting Opioid Abuse

While some major national drugstore chains offer naloxone without a prescription, CVS said it will now automatically apply a coupon for Narcan nasal spray-the only FDA-approved nasal administration of naloxone-for patients without insurance. The resulting out-of-pocket cost of $94.99 is the lowest net price available on the market for patients without insurance, according to CVS.

"CVS Health is dedicated to preventing and addressing opioid abuse in the communities we serve," says Thomas G. Davis, RPh, vice president of professional services at CVS Pharmacy. "We are proud to support the advisory issued by Surgeon General Adams by enhancing our ongoing efforts to educate patients about the life-saving importance of naloxone. We are also pleased to work with Adapt Pharmaceuticals to provide a coupon for Narcan nasal spray to CVS Pharmacy patients without insurance and we appreciate their partnership.”

Walgreens also stocks Narcan in all of its more than 8,000 pharmacies nationwide. The drug store chain also offers naloxone without requiring a prescription in 46 states and says it “continues to work to make the medication easier to obtain in the remaining states.”

While pharmacy chains are making strides in improving access to naloxone, the cost of the drug has come under fire. “It can be expensive – the brand version Narcan Nasal Spray costs around $130 and the auto-injector Evzio can be up to $4,500,” says Lewis Nelson, chair of the Department of Emergency Medicine at Rutgers New Jersey Medical School. However, “most insurance will cover a version of naloxone if the person has a prescription, so that would be the cheapest way to get it,” Nelson advises.

Related article: Fighting Opioid Misuse: The Numbers

Meanwhile, NACDS President and CEO Steven C. Anderson thanked Adams for “a very clear and effective message: carrying naloxone can help save the life of a loved one.”

Anderson notes that fostering naloxone access is one of the ways that pharmacies serve as part of the solution to the opioid abuse epidemic. Other ways include: conducting patient education about opioids; advancing drug disposal solutions to help prevent opioids from falling into the wrong hands; helping to pioneer and expand electronic prescribing to reduce fraud and abuse; implementing pharmacy compliance and security programs; collaborating to stop illegal online drug-sellers; and recommending public policy changes based on pharmacists’ experience on the front lines of care.