How one company profited while delaying Narcan’s drugstore debut

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Access to Narcan, a lifesaving drug that reverses overdoses, has been limited by Emergent BioSolutions’ hunt for profits, including a five-year delay in bringing it over the counter.

Now, the company’s fate is closely tied to the opioid epidemic. Narcan accounted for 47 percent of Emergent’s revenue in the first half of this year, according to corporate filings.The magic of Narcan is its active ingredient. Naloxone targets the same brain receptors as heroin and fentanyl, dislodging the chemicals that can slow breathing and starve the brain of oxygen.

Two years ago, Julie Stampler saw a nurse performing CPR on a teenager who was passed out on a New York City subway platform. “He was essentially dead. No pulse. No breathing,” Stampler recalled. She always carried Narcan. Her stepfather, Jack Fishman, had co-discovered naloxone. And in 2003 her brother had died of a heroin overdose. Now, in the subway, Stampler used the naloxone nasal spray on the knocked-out teen.

In 2012, the agency held a public meeting to get the pharmaceutical industry excited about the overdose treatment, taking a page from harm reduction groups, which already were handing out liquid naloxone and syringes to drug users in Chicago and other cities. Naloxone was simple to use, especially for heroin users comfortable with a syringe. And injectable naloxone was inexpensive., an auto-injector that worked like an EpiPen. But its price tag, which eventually hit $4,000, sank it.

The name was already like the Kleenex of harm reduction: Narcan was the original brand name for liquid naloxone. Adapt capitalized on that and bought the rights to the famous name from Endo Pharmaceuticals, promising 2 percent of annual sales, according to information revealed in a patent lawsuit. Emergent’s Abdun-Nabi praised the acquisition as “directly in line with our mission — to protect and enhance life.”Government money for fighting the opioid epidemic — and buying naloxone — was just starting to flow.in federal Substance Abuse and Mental Health Services Administration grants to fight opioid problems would go to states from 2017 to 2022. States, counties and cities then bought more naloxone with their own money, too.

Emergent lobbyists also pushed state politicians to draft laws making it easier to get naloxone. Every state eventually approved “standing orders” so anyone could get naloxone from a pharmacist without an individual prescription. Some states also passed laws encouraging doctors to co-prescribe naloxone with strong painkillers.

 

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