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With the opioid crisis, police, firefighters and paramedics are responding to more overdoses than ever. They often take along naloxone, which can save lives. But the rising cost of the drug is taking a toll on emergency response programs. NPR's Alison Kodjak reports.
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ALISON KODJAK, BYLINE: We're at the Franklin Square firehouse in downtown Washington, D.C. Two trucks just returned from a call and are backing into the station.
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KODJAK: Battalion Chief Mark St. Laurent pulls out the equipment bag the EMT use when they respond to a medical emergency.
MARK ST. LAURENT: So this is the bag that was just utilized at 14th and Constitution to engage to save a man's life who was in respiratory arrest. So this is the truck's bag. And there's their Narcan locked and ready to go.
KODJAK: Narcan - it's the most common brand name of a drug called naloxone that firefighters and EMTs use to save the lives of people who overdosed on heroin or prescription opioids. In the bag that St. Laurent just opened, there's a vial of naloxone and a syringe right on top.
ST. LAURENT: We're using it pretty commonly, probably on a daily basis. Rough estimate - somewhere between 12 to 18 times a day we'll get utilizations of it.
KODJAK: Naloxone is sort of a miracle drug. It can literally breathe life back into someone who has stopped breathing because of an overdose. It doesn't always work, of course. And St. Laurent says as street drugs have become stronger, emergency responders often need more than the standard 2-milligram dose.
ST. LAURENT: A couple of times where I'm looking at 6, 8 milligrams of - sometimes 10 milligrams to get them to breathe.
KODJAK: Naloxone has been around for decades. But in the last few years, as opioid overdoses have skyrocketed, so has its price. The D.C. Fire Department paid $6 for a dose in 2010. This year, that same vial cost $30. The city spent $170,000 on naloxone in the last 10 months.
Next door in Prince George's County, Md., the fire department expects the number of doses it uses to rise 40 percent this year to 1,200. Bryan Spies, the county's battalion chief in charge of emergency services, says all emergency responders keep naloxone at hand.
BRYAN SPIES: We carry it in our first-in bags. Whenever we arrive at a patient's side, it's in the bag, along with things like glucose, aspirin, oxygen.
KODJAK: Even the bomb team carries it.
SPIES: For the bomb dogs because obviously they're sniffing a lot of things in a lot of different places.
KODJAK: The price increase has been driven by new, easy-to-use forms of naloxone. One automatically injects the drug. Another is a nasal spray. They cost more because of the complicated delivery devices, says Richard Evans of SSR Health, an investment research firm.
RICHARD EVANS: Yeah. In the case of naloxone, the generic drug substance is really cheap. You can get a dose of naloxone for as cheap as $3.43.
KODJAK: But that's not in a form that can be used by emergency responders. The generic naloxone used in D.C. and Prince George's County are far pricier. The rising costs have caught the attention of Missouri Senator Claire McCaskill. Last week, she sent letters to four companies that make naloxone, looking for details on prices and discount programs. She's particularly concerned about the Evzio auto injector whose list price is more than $2,000 a dose. That price baffles Richard Evans as well.
EVANS: Look, I'll tell you, a quarter century in the business and I'm scratching my head to guess what their reference point was for a $2,000 list price. I really have no idea.
KODJAK: Kaleo Pharma, which makes Evzio, says nobody pays the list price because they offer discounts and rebates. But even with the rising prices, demand for naloxone keeps increasing. Last week, the president opioid commission recommended all police officers carry the drug, and that's a formula for even greater price hikes in the future. Alison Kodjak, NPR News, Washington.
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