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"Simple" medications priced EXTREMELY high due to route of administration (single use) - Narcan

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posted on Aug, 20 2018 @ 04:02 PM
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I was listening to NPR and some other news stations about the increase of various "life saving" medications which have increased in price anywhere from 400% to 6,000%+ over the last few years, and the main ones they were talking about are Narcan (for opiate overdose) and Norepinephrine (Epi-pen). The thing is that the medication formulation of these products hasn't changed since they came out, but the main difference is the mode of administration. With the Narcan, it is a pre-measured, single use nasal inhaler much like what you would use with a product like "Afrin" (the nasal decongestant) - it just sprays a mist into the nose. The Epi-pen is a pre-loaded single use auto-injector - it's like a syringe that injects the medicine when it is jabbed into the leg, or wherever. The thing is that each of these use the same dose and basically the same route of administration as years before, but the difference is that they have made slight changes to the application device which the manufacturers claim makes it "easier" to use.

Well when a single dose of Narcan used to cost $10-20 with a standard syringe, glass ampule and an aspirator end (instead of a needle) and now some sell these for almost $6,000 per unit, that is a major difference in price. I wonder if it has to do with the fact that the governement (local EMS) pays for this, along with insurance??

Norepinephrine/adrenaline, also used to be about the same price for a small vial/ampule with a syringe much like what a diabetic uses. The syringe could be pre-loaded with the medicine so if it was needed in an emergency, it was ready to go, or it could be loaded at that time in about 5-20 seconds (depending upon how "skilled" one is in it).

Now I just can't see how any insurance company can cover these outrageous costs, and when I hear about them pushing for Narcan to become common place (in every school, and even classrooms, in households, businesses, etc) it seems like there is a little bit of greed behind this.

I can't imaging how an EMS company, police or emergncy responders can justify ordering the "new product" when the old stuff works just as well, and it can be used by the professionals in just about the same time as it does to unwrap the packaging for the Narcan (yes, it takes about the same time!)

The reason that these prices have gone up isn't because the medicine is still in patent, it is because the administration device is in patent. Once these current patents on the applicator run up, they will come out with a slight change, to keep the patent alive (although a different patent number) and keep the price the same, if not raise it.

I'm curious if anyone has had to deal with either of these products and can tell me if there is a reason why the expensive products are better than the less expensive ones. If an "addict" has a pre-loaded syringe with Narcan with a nasal aspirator on the end in his house, is that product any less effective than the new $6,000 product? Same with the Epi-pen. A pre-loaded syringe, ready to jab, for about $20 vs a $2,200 epi-pen, are they going to be cured better with the more expensive product?

In both cases we are talking about administering anywhere from .4ml to 2ml of solution, which should take about 2-4 seconds (at a SLOW pace). I only see greed an profit motivation behind these new "inventions" and a fleecing of the public's tax dollars. Please, EMS and medical professionals, please tell me if this is incorrect, or if there are actual benefits that support this extra gouging of our $$.




posted on Aug, 20 2018 @ 04:33 PM
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a reply to: DigginFoTroof

Talk to your doctor if you feel that there is a risk that you will need a Narcan (for opiate overdose) or Norepinephrine (Epi-pen). The doc can write you a prescrition, and your local pharmacy will supply you. Doc will write a presciption for Narcan even if you have no immediate need.

My wife has allergy problems and got an Epipen for about $120 bucks. If you think you might need a Narcan injector (everyone in the US should have one if you are serious about having a well stocked first aid kit) they run about $70 to $90 dollars.

Our local governments cannot afford to buy all of the Narcon kits that are needed by our society right now. Buy one, put it away, and maybe you save a life some day. I don't use opiates very often (dentist, back pain a few years back) but this is a serious epidemic in our country. You never know when a neighbor who was hurt at work, or a kid who just isn't thinking right might need the life-saving shot. Put out $100 bucks and save a life!

Off-topic: get a good first aid kit, not one off the shelf with a few bandaids. Go to a pharmacy and buy some heavy guaze, tape, and a bottle of alcohol. Most folks who get hurt bleed out. It can happen in a few minutes. Check out the internet or advice, and get some gear that can really help someone.



posted on Aug, 20 2018 @ 04:36 PM
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A epi pen just has epinephrine. Norepinephrine is used for something else. We still draw up our narcan. It comes in 2 mg, we then add a atomizer to the tip of the syringe and shoot it up the nose or if we can get a line it’s a slow push. Fast push, you’ll make the patient throw up. I don’t know how my county picks the companies they buy from but it’s a government job. So, cheapest bidder is the way they go. In the past, I know if stuff was too expensive, they wouldn’t buy and adjust our protocols.

I see them upping the cost because the police now carry narcan and drug users can get it. So some one is paying for it. Boggles my mind when narcan is free for drug users and families scrap money together to afford an epi pen.



posted on Aug, 20 2018 @ 04:40 PM
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The FDA just approved a generic epipen that circumvents the rip off artists that raised the price to unsustainable levels.



posted on Aug, 20 2018 @ 04:58 PM
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I was trying to help my elderly mother find a cheaper prescriptions so I tried Canadian pharmacy on line. Very cost effective and if you place one order, they will only call a million times. And sell you number and email address to everyone in the freaking universe.



posted on Aug, 20 2018 @ 08:27 PM
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originally posted by: schuyler
The FDA just approved a generic epipen that circumvents the rip off artists that raised the price to unsustainable levels.

That's good.

Medicine should be a humanitarian endeavor, not obscene profit gouging.

We somehow afforded things before when they were cheaper.



posted on Aug, 20 2018 @ 08:46 PM
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Unfortunately investment companies have the millions to buy all the drugs in the world and charge whatever they want for them, knowing that some governments subsidise the costs. So its a problem with our economic model. Instead of guaranteeing competition its doing the opposite, allowing mega corporations to rule the economic world.



posted on Aug, 20 2018 @ 10:04 PM
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I researched the epi-pen when the Pharma-bro was on trial and Narcan about 2 years ago when there was a push to allow more wide spread access (not even necessarily prescription. You can walk into a pharmacy and buy narcan w/o a script now in many states. I called 4 states and 3 pharmacies in each state. The price is $135 at each of these for the cash price. What they did tell me is that if it is prescribed that the price can be anywhere form Zero to up to $20 or so. That isn't so bad out of pocket, or even with the cash price, considering what the "retail" price is listed from the manufacters (Narcan is a brand name, there are other "brand" names, some MUCH more expensive).

What I found that is really concerning is the price the pharmacies charge the insurance companies, and I'm still trying to confirm the "behind the scenes" pricing of the "cash price" at the pharmacies. From what I have been told is that there is something subsidizing these cash price purchases to make up the difference between what the manufacturer charges to what the $135 price is. I'm guessing it is re-imbursed by some government agency (HHS?) medicade, medicare, or some states "anti-opioid abuse task force".

I've found that some people who buy through scripts and get it for "free" (no co-pay), well it isn't quite free. A Pharmacy may get $786 from the insurance company for filling the no-co-pay prescription and the thing is, depending upon your insurance coverage, say you have a maximum of $3,000 per year of mediactions covered, that "free" medication takes up 1/4 of your yearly allotment for medication - as explained in your "benefits statement". Some pharmacies charge even more, some less, but it all gets subtracted from the yearly allowed medications your insurance allows. In cases like this, it may be less expensive for the buyer to pay the $135 out of pocket but that brings up another issue.

Now some EMS companies get the medication at a discounted rate as well, but SOMEONE is paying for it on the back-end, whatever the government subsidiy is. So the one company (Evzio) is charging about $4,500 per dose of a different name brand of "Narcan" the drug is called Naloxone.
Here is an article about the price of $4500 - up from $690 2 years ago.

www.nejm.org...


This wiki on Naxolone talks about price increases and other issues that are important

en.wikipedia.org...


So when the "epedemic" was all the rage in the news about 2-4 years ago, there was a huge push to "do anything" to stop the deaths by OD, and they wanted teachers, care givers, police, FD, EMS, security gaurds, etc to have "Narcan" and at the same time there was a HUGE increase of price from 400-900% - seems like this push might have been profit driven. (I'm not saying the fentynal push wasn't part of the plan, but I'm not saying it wasn't either - but this isn't a conspiracy post).

So, from my research I found that there is some kind of government kickback, repayment, subsidy, or whatever it is called and however they snuck it in, to pay the manufacturer to off-set selling the drug "cheap" at $135 per dose. So maybe everything you get that "cash price", the company is getting $400-1,000 per dose (from some government related agency/org/etc) to make up the difference in price. I remember hearing this on Vice years ago and reading it in a number of online newspapers around the same time as that guys trial for upping drug prices 500-2500%. I didn't know much about it at the time so I didn't know how it was all working until I recently looked into it again.

I'm trying to find out how these state programs that are providing Narcan (and it is usually that brand it seems) are being funded, how to find if there are "rebates", tax-credits, or whatever is being used to "give $$ back" to the manufacturer for providing low cost meds to the public. If anyone has any inside knowledge on this, I'd really like to hear about how it works.

If you work for a pharmacy, insurance agency, government agency, etc, and are involved with this, please contact me (messaging is fine) as I've come up against road blocks when trying to contact people at state health dept's, federal HHS, etc. IF anyone knows what legislation was passed to enact this, that would help too.

The long a short is that I think there is still MASSIVE profit making going on, and it is being hidden by layers of beurocracy and they are fooling the public into thinking they are getting it "cheap" or "free" when it is nothing anywhere near that. These types of things have been going on for decades and it usually doesn't get caught until after the issue is over for years or decades when someone blows the whistle.

On another note, 1kg of this drug is enough for 500,000 "normal doses" and 250,000 "strong doses". even at $135/dose (extremely low for "US pricing" from the manufacture) is about $34 million/kg and there isn't a lot of cost into the manufacture of this with ingredeitns of Saline solution, HCl (ph buffer) and Naloxone (which I won't even tell you how inexpensive this is at USP/BP pharmaceutical grade..) now imagine if they are getting $500-$4,500 per dose! That would mean $100 million to $900 million per kg of the drug - much more profitable than even sell fentynal as "heroin"... Makes you wonder where the real profit motive is.


edit on 8 20 2018 by DigginFoTroof because: (no reason given)

edit on 8 20 2018 by DigginFoTroof because: (no reason given)



posted on Aug, 20 2018 @ 10:52 PM
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The price rose because of profit taking, they always had the single application systems. I actually read an article about the epipen manufacturers coming out and plainly stating they wanted to make more profit. There are some generic versions that are almost a fifth of the price, the big patent gouging is from their belief their epipen is better. If they sell a fifth as much they will still make the same thing...actually more profit because of less overhead.



posted on Aug, 21 2018 @ 12:15 AM
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I see that and when I saw the news shows, the new resporter (on the street interviewing people) was going up to people who looked like they were poor as can be (inner city "ghetto") and they were saying "I can't afford this now. My child is used to this product and we can't go back to an inferior product". What is sad is that "inferior product" was top of the line for 30-80 years and now all of the sudden, these people who don't pay for their medical devices, demand the top of the line and feel they are being "cheated' if they don't get it and raise a big stink about it. The reporter even told them that there were less expensive options and the interviewee acted insulted like "you expect me to take sub-par medication that could save my child's life?" This was the same person who had used 5-6 of them in the last year alone, all for false alarms as well. That really infuriated me because the person could barely string together a sentence and looked like she hadn't showered in 2-3 weeks or done laundry for longer. I'm sure she was paying for these as well.



posted on Aug, 21 2018 @ 07:03 PM
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originally posted by: DigginFoTroof
I was listening to NPR and some other news stations about the increase of various "life saving" medications which have increased in price anywhere from 400% to 6,000%+ over the last few years, and the main ones they were talking about are Narcan (for opiate overdose) and Norepinephrine (Epi-pen). The thing is that the medication formulation of these products hasn't changed since they came out, but the main difference is the mode of administration. With the Narcan, it is a pre-measured, single use nasal inhaler much like what you would use with a product like "Afrin" (the nasal decongestant) - it just sprays a mist into the nose. The Epi-pen is a pre-loaded single use auto-injector - it's like a syringe that injects the medicine when it is jabbed into the leg, or wherever. The thing is that each of these use the same dose and basically the same route of administration as years before, but the difference is that they have made slight changes to the application device which the manufacturers claim makes it "easier" to use.

Well when a single dose of Narcan used to cost $10-20 with a standard syringe, glass ampule and an aspirator end (instead of a needle) and now some sell these for almost $6,000 per unit, that is a major difference in price. I wonder if it has to do with the fact that the governement (local EMS) pays for this, along with insurance??

Norepinephrine/adrenaline, also used to be about the same price for a small vial/ampule with a syringe much like what a diabetic uses. The syringe could be pre-loaded with the medicine so if it was needed in an emergency, it was ready to go, or it could be loaded at that time in about 5-20 seconds (depending upon how "skilled" one is in it).

Now I just can't see how any insurance company can cover these outrageous costs, and when I hear about them pushing for Narcan to become common place (in every school, and even classrooms, in households, businesses, etc) it seems like there is a little bit of greed behind this.

I can't imaging how an EMS company, police or emergncy responders can justify ordering the "new product" when the old stuff works just as well, and it can be used by the professionals in just about the same time as it does to unwrap the packaging for the Narcan (yes, it takes about the same time!)

The reason that these prices have gone up isn't because the medicine is still in patent, it is because the administration device is in patent. Once these current patents on the applicator run up, they will come out with a slight change, to keep the patent alive (although a different patent number) and keep the price the same, if not raise it.

I'm curious if anyone has had to deal with either of these products and can tell me if there is a reason why the expensive products are better than the less expensive ones. If an "addict" has a pre-loaded syringe with Narcan with a nasal aspirator on the end in his house, is that product any less effective than the new $6,000 product? Same with the Epi-pen. A pre-loaded syringe, ready to jab, for about $20 vs a $2,200 epi-pen, are they going to be cured better with the more expensive product?

In both cases we are talking about administering anywhere from .4ml to 2ml of solution, which should take about 2-4 seconds (at a SLOW pace). I only see greed an profit motivation behind these new "inventions" and a fleecing of the public's tax dollars. Please, EMS and medical professionals, please tell me if this is incorrect, or if there are actual benefits that support this extra gouging of our $$.



I carry 3 er. admin.s of Narcan, and 2 adult and 2 pediatric dose epi-pens in my car 24/7. A first responder... these I pay for myself... Each roughly is around and / or about $125-200+ per dose...

Bad thing is... They expire and must be replaced... and Narcan can take a couple to work on a heavy o. d. I wish they we're cheaper... even tho I get them for me at the station.

Outta 70+ workers... I'm the only one certified in Advanced Disaster Life Support at my day job.. so it's on me if I want to carry them... so I do. Everywhere. Home, vacation, church.....

But... It's so expensive... It's unfair... and the replacements frequent. *I'm not required to carry these off duty... But a 24/7 responder.. I just feel I should.

MS
EMT/ERT
ADL SUPPORT
Dept. of H. Security/FEMA/
Wayne County CERT, Region 2 South
Michigan, USA
edit on 21-8-2018 by mysterioustranger because: Oops



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