How the drug industry uses fear of fentanyl to extract more profit from naloxone

Updated with the approval on Wednesday of an over-the-counter form of naloxone.

As the U.S. drug crisis has accelerated, the pharmaceutical industry has jumped into action — particularly when it comes to naloxone, the drug used to reverse opioid overdoses.

In recent years, companies have introduced a dizzying array of ambitious new naloxone products. They include a mechanized injector that gives robotic voice commands, a prefilled syringe pen, an ultra-high-dose nasal spray, and an autoinjector that the Pentagon has purchased for use in the event of a terrorist attack.

At first glance, the race to create stronger, more advanced overdose-reversal tools seems like a win-win: a case study in American pharmaceutical companies saving countless lives and turning a profit along the way.

A new STAT examination, however, captures a far different reality: One in which pharmaceutical companies have used the opioid crisis, and the nation’s fear of fentanyl, to aggressively market high-cost naloxone products that divert resources away from cheaper forms of the lifesaving medication. These expensive new products, according to researchers, harm-reduction groups, doctors, and pharmaceutical industry experts, don’t fill a legitimate public health need. Instead, they serve largely as an excuse to charge exorbitant prices for a medication that has been off patent for nearly 40 years.

“The average person would assume that a higher dose is stronger and perhaps can work better,” said Robert Ashford, a substance use researcher and advocate who runs Unity Recovery, an addiction recovery organization in Philadelphia. “The unfortunate truth is that’s just not supported by science. The industry is grasping at straws — I think for a profit motivation, not a scientific or medical one.”

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