Pubdate: Sun, 26 Apr 2015
Source: Boston Globe (MA)
Copyright: 2015 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Jeff Jacoby

WHAT PRICE IS TOO HIGH FOR A MIRACLE DRUG?

Naloxone isn't magic, but its power to rescue a heroin user from the 
brink of death can certainly seem miraculous. The anti-overdose drug, 
also known by the brand name Narcan, is easy to administer and has 
saved thousands of lives. First responders are often awestruck at how 
swiftly it can revive a dying addict.

"It's just incredible," the deputy fire chief in Revere marveled in a 
public-radio interview last year. "There's somebody who's on the 
ground who's literally dead. They have no pulse. Sometimes they're 
blue, sometimes they're black. And you administer this stuff and 
sometimes in a minute or two or three, they're actually up and talking to you."

Free markets aren't magic either. Yet their ability to generate a 
life-saving drug like naloxone, supplying quantities sufficient to 
make it widely available even when the need is great, can seem even 
more miraculous. That miracle is not enhanced when politicians rebuke 
the entrepreneurs who manufacture or distribute such wonder drugs for 
charging a price that the market will bear.

Politicians, for instance, like Massachusetts Attorney General Maura 
Healey. She lists opiate abuse among her most urgent public concerns, 
yet is going out of her way to pick a fight with vendors who actually 
help make things better.

In recent years, drug overdoses have surpassed automobile accidents 
as the leading cause of death from injury in the United States. 
According to the Centers for Disease Control, opiate painkillers 
alone account for 16,000 fatalities annually; deaths involving heroin 
have increased fivefold since 2001.

Amid this grim crisis of opioid overdoses, naloxone has been a 
godsend. While public-health experts debate the causes of the 
epidemic, officials nationwide have been moving rapidly to expand 
access to the drug. The National Conference of State Legislatures 
reports that 30 states and the District of Columbia have adopted a 
variety of measures to facilitate the use of naloxone. Among those 
measures: allowing it to be administered by non-medical personnel, 
paying for police and firefighters to carry supplies of the drug, and 
permitting pharmacies to dispense naloxone without a prescription.

Of course, with demand for the medication skyrocketing, the price has 
climbed as well. The workings of economics apply to pharmaceuticals 
just as they apply to housing, bourbon, iPhones, or tickets to NFL 
playoff games. When demand for a product or service rises, the price 
of that product or service can't help but rise in response. That is 
especially true when the growth in demand has come about quickly or 
in unexpectedly short order. Heroin overdose rates have increased 
markedly since 2010, and only in the last year or two has there has 
been such a strong push by state and local authorities to equip first 
responders - police officers, sheriffs, firefighters, and even 
civilian bystanders - with naloxone kits.

In the midst of an opioid epidemic, naloxone is saving lives. So why 
attack the entrepreneurs who make and distribute it?

So it stands to reason that in Massachusetts, as in most other 
states, the price of naloxone is up sharply. A 2-milliliter dose that 
used to cost the state $19.56 has more than doubled to $41.43. That's 
a sizeable increase, and it is putting a strain on public-safety and 
drug-treatment budgets.

The price jump may be unwelcome - no one likes to pay more for vital 
supplies - but it is hard to see anything unfair or unethical, let 
alone unlawful, about it. That hasn't stopped Healey from demanding 
that companies selling naloxone in Massachusetts provide detailed 
explanations for the higher costs of the drug, and account for "any 
changes in prices over time" since the opioid crisis was declared a 
public emergency. Healey's spokesman insists the attorney general 
"isn't suggesting anything nefarious," and is simply conducting "a 
fact-finding mission." But the innuendo is hard to miss.

Healey has said she is just being "aggressive" and wants to be sure 
"that nobody is out there unnecessarily profiteering from a public 
health crisis." Yet who is the real "profiteer" here? The drug maker 
who responds to an unprecedented surge in demand for a critical 
medication by raising prices to ensure that inventories of the drugs 
aren't immediately depleted? Or the ambitious politician, who sees a 
chance to score political points by posing as a defender of the 
public against the very suppliers who are making available what the 
public needs?

Demand for naloxone is way up; consequently the price of naloxone is 
up. Eventually the price will fall, as new supplies come on line. In 
the meantime, thanks to the workings of the market, more lives are being saved.
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MAP posted-by: Jay Bergstrom