(NEWS CENTER Maine) -- The name brand NARCAN is often used synonymously with the overdose reversal medicine naloxone.
Naloxone is the active ingredient in overdose reversal medicines like NARCAN or EVZIO, and is used to rapidly reverse an opioid overdose.
There are three FDA-approved forms of naloxone: injectable, autoinjectable, and nasal spray. Many pharmaceutical companies are under scrutiny from federal lawmakers to keep prices of the potentially life-saving medicine affordable.
Senator Susan Collins has written letters to major companies, including Pfizer, asking them about increases in prices to naloxone.
418 people died in Maine in 2017 due to a drug overdose, according to the Maine Attorney General's Office.
"If it can make a difference for one person, then it did its job and we really need to work on finding resources and making sure that individuals get treatment," said Westbrook Fire Department Chief Andy Turcotte.
Westbrook Police and Fire are just two of hundreds of departments in the state that carry naloxone. The Fire Department budgets about $1,000 a year for naloxone, estimating about 50 overdoses a year.
NARCAN refers to the nasal spray frequently used by first responders to help someone experiencing an opioid overdose.
An autoinjectable version, EVZIO, has a list price of $4,100, but spokesperson Jennifer Corrigan said people almost never pay that price, saying, "they do not account for the numerous discounts, rebates, chargebacks and other price concessions that are routinely negotiated in the healthcare system."
EVZIO plays audio step-by-step instructions for someone to administer the dose of naloxone.
Corrigan said Kaléo has a "direct purchase price" of $180 per auto-injector of EVZIO ($360 per pack of two auto injectors and a trainer) for all federal and state government agencies and tribes who purchase the product directly from the company.
Chief Turcotte said the price of the two-pack of autoinjectors jumped significantly since it was approved by the FDA in 2014.
On social media, people are criticizing the high price of the drug.
"It's sickening to see a company that has a life-saving drug do everything they can to charge the maximum amount of money," said Seth Blais, who is in recovery and now writes columns for Maine's two largest newspapers. "When the need for the drug is highest, pharmaceutical companies look to make a profit."
According to Corrigan, patients with commercial insurance pay $0 out of pocket for EVZIO. The same goes for patients without commercial insurance and incomes below $100,000.
While injectable naloxone with a syringe can often be the cheapest option, it requires medical training."
"It's hard to ask the general population to do that versus we have a technology that makes it very simple and easy," said Blais. "Let's get that into as many hands as possible."
Many of the companies offer grants for free naloxone.
Kaléo, which manufactures EVZIO, has a donation program for first responders who can submit a grant request for free product. Corrigan said 50,000 EVZIO auto-injectors have been donated, free of charge, to first responders and community groups to date. She estimated those donations lead to a reported 5,400 lives saved.
Milestone Foundation, one of two non-hospital in-patient detox facilities in Maine, received free autoinjectors.
Adapt Pharma, which manufactures NARCAN, gives a 40 percent discount to first responders and state agencies, making a box of two 2 milligram doses cost $75.
The cash price of two doses is typically $90 to $135, according to Thom Duddy, Vice President of Corporate Communications for Adapt Pharma. He said only about three percent of patients pay cash. Co-pays range as high as $20.
"If you don't have access to affordable naloxone, we won't make a very big impact on this epidemic," said Duddy.
NARCAN has an entire section on its website dedicated to affordability (click here). They offer free NARCAN every high school, college or university free-of-charge. For high schools, they also built a toolkit to educate students, staff, and parents about opioid overdoses and how NARCAN works.
"I think all of these life-saving drugs should be readily available to the public," said Westbrook Fire Department chief Andy Turcotte. "People also need access to longterm recovery."
"We looked at high schools as an educational format, and in rural America, they're the centerpoint of most communities, the focal point of most communities. People go there to vote, lots of activities in high schools. To have naloxone in those locations is positive," said Duddy.
In Maine, residents can obtain NARCAN Nasal Spray without a prescription, directly from a pharmacist. Download this prescription request or email and talk to your pharmacist today.