Updated Aug 30, 2023 - Health

Narcan is coming to drug store shelves — for those who can afford it

Photo illustration collage of a Narcan package falling out of a plastic shopping bag in front of a background showing a gas station

Photo illustration: Annelise Capossela/Axios. Photos: Scott Olson, Spencer Platt/Getty Images

The first opioid overdose treatment to be sold without a prescription will hit store shelves next month — but at a price some experts worry is too high for widespread use.

Why it matters: The individuals with the greatest need might not be able to afford a co-pay, if health plans even opt to cover over-the-counter Narcan, which will retail for $44.99.

Driving the news: Manufacturer Emergent BioSolutions said on Wednesday that it's begun shipping out the two-dose, 4-milligram spray version of naloxone under the Narcan label to retailers like Walgreens, Walmart and Rite Aid.

  • The initial distribution will be "several 100,000 cartons of Narcan," said company spokesperson Matt Hartwig.
  • State and local government programs and harm reduction groups who distribute the treatment at no cost will be able to buy the packages for $41 starting Aug. 31.
  • Pricing could still vary depending on the retailer.

Zoom in: On Tuesday, Blue Cross Blue Shield of Massachusetts announced that it would fully cover over-the-counter Narcan for members.

  • Medicaid private plans have the option of covering OTC drugs but might require state agencies to first add naloxone to formularies, according to the National Health Law Program.

State of play: The Food and Drug Administration approved selling Narcan without a prescription in March after FDA advisers unanimously endorsed it in February.

  • RiVive, another over-the-counter naloxone nasal spray, won approval in late July and could be available early next year at a lower price than Narcan.
  • Naloxone acts in a fraction of the time it takes EMS technicians to arrive, which is critical when fentanyl can render a person unconscious within 90 seconds.
  • The presence of synthetic opioids more potent than fentanyl, like nitazene, could require up to four doses of naloxone, meaning multiple packs.
Go deeper