Price of Life-Saving Naloxone Injector Goes From $690 To $4,500 Per Unit

By Paul Gaita 02/03/17

Evzio has been in high demand since it won federal approval in 2014.

Evzio naloxone injector
Evzio Photo via YouTube

As the epidemic of opioid-related deaths in America continues to grow, a pharmaceutical company has decided to raise the price of one of its products—which administers doses of the opioid overdose reversal drug naloxone—from $690 to $4,500 per unit (each package comes with two auto-injectors).

The privately owned, Virginia-based Kaleo initially developed Evzio as competition for the EpiPen, but found greater demand for the product as a naloxone auto-injector. What sets Evzio apart from other naloxone devices is that it has a "talking" component that assists the average person in properly delivering the dose. 

As a result, Evzio has been in high demand since it won federal approval in 2014; according to the Food and Drug Administration, the product accounts for nearly 20% of all the naloxone dispensed through retail outlets between 2015 and 2016, and for almost half of all naloxone products prescribed to patients between the ages of 40 and 64.

Kaleo has stated that the talking technology element—as well as escalating prices for generic, injectable naloxone—accounts for the steep increase in cost, but medical professionals and industry observers disagree. "There's absolutely nothing that warrants them charging what they're charging," said Leo Beletsky, associate professor of law and health sciences at Northeastern University.

Kaleo has countered such arguments by offering more than 180,000 Evzio devices for free to about 250 organizations, first responders and drug-treatment programs in 34 states, and coupons to patients with private insurance to assist with co-payments for the product. But again, the gestures don't offset the long-term problems with the cost hike.

As Eliza Wheeler, from the non-profit Harm Reduction Coalition in San Francisco, noted, "I might have $10,000 to spend on naloxone for a year, to supply a whole city. If I have 10 grand to spend, I certainly can’t buy two Evzios." 

Adding to the problem is the ever-increasing demand for naloxone due to the opioid epidemic, which exhausted Kaleo's charitable donation supply in July 2016. The company subsequently issued a statement that no new applications for free product would be reviewed until January 2017, leaving a lot of overwhelmed organizations in dire straits. Aimee Dunkle, who co-founded Orange County's Solace Foundation after the opioid-related death of her son, said, "If we don't have naloxone, we'll start losing people."

And while co-payment coupons may offset immediate costs, the price hike will ultimately be forced upon consumers. "When you have these kinds of programs, the cost is still borne by patients, because insurance premiums go up," said Beletsky. 

So far, the price hike hasn't cut significantly into demand for Evzio; according to Mark Herzog, Kaleo's vice-president of corporate affairs, the number of prescriptions increased after the announced price increase. But as the demand for naloxone increases, so too will the need for policymakers to address extravagant cost hikes.

Unfortunately, as the uproar over both EpiPen and Daraprim illustrated, there seems to be no set idea of how to properly rein in costs and get medication to those in need. "Epi-Pen happened, and everyone was like, ‘Wow, this is terrible, we shouldn’t allow this to happen,'" said Nicholson Price, an assistant professor at the University of Michigan Law School. "And we haven’t done anything about that, and it’s not clear what the solution is. Now, shocker, it’s happening again."

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.