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October 3, 2017

Miller Reaches Deal to Cut Public Agency Price for Life-Saving Opioid Antidote

Agreement with drugmaker Amphastar provides naloxone rebates to public agencies statewide, including first responders

DES MOINES – Public agencies across Iowa, including medics, law enforcement and public hospitals, will pay less for the heroin and prescription painkiller antidote naloxone, through a rebate agreement Attorney General Tom Miller reached with drug manufacturer Amphastar Pharmaceuticals Inc.

The California-based drug manufacturer agreed to provide a $6 rebate per dose to any “public entity” in Iowa, including those at the state, regional, county or city level. The two-year agreement, which took effect this week, provides the rebate regardless of where the agency purchased the drug.

Naloxone Stops and Reverses Opioid Overdose
Naloxone revives a person experiencing an opioid overdose by quickly stopping and reversing its effects. It does not counteract other types of drugs, such as methamphetamine or cocaine.

When a person overdoses on an opioid drug, such as heroin, and certain prescription painkillers, such as hydrocodone, oxycodone, or morphine, the person’s breathing may slow or even stop. Naloxone counteracts the effects and can very quickly restore breathing.

“Quite literally, naloxone may be someone’s only lifeline if they overdosed on prescription painkillers or heroin,” Miller said. “While we’re fortunate to have naloxone and it’s so effective, we must also realize that making it available impacts budgets that fund Iowa’s first responders and public health care providers,” Miller added. “I’m pleased we were able to negotiate this rebate through Amphastar to help reduce these costs.”

Survey: Iowa Public Agencies Generally Pay $23-48 Per Dose
There are more than 900 EMS providers in Iowa. Providers generally pay $23-$48 per dose, according to a statewide survey conducted by the Iowa Department of Public Health and Miller’s office.

"Importantly, this agreement means naloxone will be a little more accessible and affordable to first responders who use this life-saving tool to rescue Iowans from opioid overdoses," said Steve Lukan, Director of the Governor's Office of Drug Control Policy (ODCP). ODCP will administer the rebates in Iowa.

Opioid Epidemic in U.S.
The nation’s opioid epidemic has led to an increased demand for the antidote used to treat overdoses. According to the Centers for Disease Control’s (CDC’s) opioid overdose data, prescription opioid deaths have quadrupled since 1999, as have prescription opioid drug sales.

Nationally, according to the CDC, 33,091 people died of an opioid overdose in 2015, or about 91 people per day, and emergency rooms treated more than 1,000 people a day for misusing prescription opioids.

Impact in Iowa
Last year in Iowa, according to the Iowa Department of Public Health, 180 people died of opioid-related causes and health care facilities admitted 2,274 patients for opioid treatment. Since 2005, opioid-related treatment admissions statewide have more than tripled.

The epidemic affects Iowa’s frontline first responders and public entities that provide medical treatment.

According to the Iowa Department of Public Health, emergency medical services (EMS) responders reported a 69 percent increase in treating opioid overdoses from 2010-2015.

In Des Moines, the fire department’s emergency medical services (EMS) division projects a 165 percent increase in administering naloxone doses by the end of this year, compared to 2012. Several of the Iowa’s larger EMS agencies report administering from dozens to hundreds of naloxone doses so far this year and last year, according to data they provided to Miller’s office:

  • Davenport MEDIC EMS: 317 (though 9/25); 319 in 2016
  • Des Moines Fire Department EMS: 180 through 9/1; 191 in 2016
  • Dubuque EMS: 32 (through mid-September); 57 in 2016
  • Council Bluffs EMS: 41 (through 9/21); 51 in 2016
  • West Des Moines EMS: 34 (through 9/21); 48 in 2016
  • Sioux City Siouxland Paramedics: 70 (through 9/22); 28 in 2016
  • Mason City EMS: 23 (through 8/31); 17 in 2016

The regional EMS provider for Cedar Rapids and surrounding communities, Area Ambulance Service, reported administering naloxone to 102 people in 2016, some of whom required multiple doses. Figures from this year were not available.

“With the needs of our communities increasing, as well as the current demand for naloxone, this rebate will greatly assist EMS agencies in caring for their patients,” Mark McCulloch, President of the Iowa Emergency Medical Services Association, said. “I’m very proud of the way Iowa has rallied to address the current opioid epidemic,” added McCulloch, who is also Deputy Chief of West Des Moines Emergency Medical Services.

2016 Law Eases Naloxone Access
A state law passed last year eased restrictions on the opioid antidote, enabling adults at risk of opioid-related overdose, and their family and friends, to purchase the drug from a pharmacy without a prescription.

Miller, States Conducting Prescription Opioid Investigation
Last month in a separate announcement, Miller announced that Iowa is part of a multistate investigation that seeks to determine whether opioid manufacturers and distributors engaged in unlawful practices in the marketing, sale, and distribution of opioids. The investigation is ongoing.

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