By Elaina Sauber
The Charleston Gazette, W.Va.
CHARLESTON, W.Va. — The rising cost of a drug that reverses opioid overdoses is affecting the budgets of local police and ambulance agencies, some of which are using multiple doses of it each day.
The Kanawha County Emergency Ambulance Authority, which also supplies naloxone to the Kanawha County Sheriff’s Office, spends between $35,000 and $40,000 a year on naloxone, supply director Jason Wilson said.
The drug’s cost has steadily risen over the past year few years, Wilson said. Three years ago, the county bought a two-milligram dose of naloxone for $15.50, he said. The price increased to $25 at the beginning of last year and is currently at around $45 per dose, he said.
Wilson, who keeps a full shelf of the drug on hand, said Kanawha paramedics respond to six to eight overdoses per day. He orders 100 units of the drug at a time.
For its part, the Kanawha County Sheriff’s Office supplies its shift commanders, assistant shift commanders and several others with naloxone, said Sgt, Brian Humphreys.
“We’re looking at giving it to everyone on patrol but haven’t gotten everything in place just yet,” Humphreys said.
Sheriff’s deputies are rarely the first ones to respond to overdoses and thus aren’t often called on to use naloxone, Humphreys said. Sheriff’s deputies used the drug to save two people in separate instances on the same day in December, shortly after deputies began carrying it, Humphreys said. They have not used the drug this year, he said.
Mylan, a company that has recently drawn criticism for its prices for EpiPen, also makes naloxone.
In June, Sens. Susan Collins, R-Maine, and Claire McCaskill, D-Mo., wrote a letter to Mylan and drug companies Amphaster Pharmaceuticals, Pfizer, Adapt Pharmaceuticals and Kaléo Pharma questioning the rising price of naloxone.
“Congress is working to combat the opioid and heroin epidemic through a multi-faceted approach that includes education, treatment, and law enforcement,” they wrote. “As one component of this effort, Congress provided funding to help first responders acquire products — including naloxone — to reverse overdose and provide training in their use. We are concerned therefore, by recent news reports that indicate the rising price for naloxone may be limiting access for emergency responders and public health departments.”
Shauna Pearson, the city of Charleston’s budget officer for public safety, said the city piggybacks on a contract that Kanawha County has with Henry Schein Inc. to purchase Narcan (a brand name for naloxone) and atomizers to administer the drug through the nose.
Pearson said the contract price of Narcan did increase after the previous deal was renewed earlier this year, but she didn’t know by how much.
If the cost of Narcan continues to rise, it’s unlikely that the city’s police department would be affected because it’s currently reimbursed for 100 percent of the cost of the drug by the federal Appalachian High Intensity Drug Trafficking Area (HIDTA) program, Pearson said. The Charleston Fire Department, though, isn’t eligible for HIDTA funds, which benefits only law enforcement groups.
David Hodges, director of EMS operations for the city of Charleston, said the fire department tries to keep at least 100 units of the drug on hand at all times. They use on average four doses of the drug each day. Hodges said the rising costs haven’t caused budgeting problems for the department, but it is something that administrators keep a watch on.
The Charleston Police Department usually buys 60 doses of Narcan and 60 atomizers when it makes an order. That costs about $2,500, Pearson said.
Since the police department’s Narcan program first started, the city has spent $9,284 on naloxone and atomizers; about $1,700 for breathing masks and $4,800 for insulated cases, for a total of $15,780.
The HIDTA program will reimburse up to $25,000 for those items, Pearson said.
Under the current contract, she said, one unit of Narcan costs roughly $41.50.
“If Kanawha County didn’t have the contract in place, it would cost us more,” she said.
Besides the number of overdoses in the area and the rising prices for the drug, the strength of the opioids that residents are using also affects how much each agency spends on the drug.
“The problem isn’t just heroin exclusively — it’s what it’s cut with. Fentanyl shuts their system down and stops them from breathing,” Charleston Police Capt. Aaron James said. Drugs such as Fentanyl and Carfentanyl, which was reported to be present in a batch of heroin that led to dozens of overdoses in the Cincinnati area recently, require the use of more Narcan to reverse an overdose. One dose of naloxone is two milligrams, James said.
“We ordered an additional case or two of Narcan to double up on what officers have in their cruisers ... a lot of officers are writing in their reports that [overdose victims] don’t respond to two milligrams,” James said.
Hodges said it’s not uncommon for first responders with the fire department to use triple the amount of a dose to reverse the effects of one overdose.
The police department first began carrying Narcan when the program began in November. Since then, it has gradually purchased more units of the drug so that eventually, all officers will have at least one dose at all times.
Copyright 2016 The Charleston Gazette