ALBANY (TNS) — A multi-million dollar state contract with a company offering an antidote for opioid overdoses will be renewed next week, irking competitors who say New York’s long-established relationship with one pharmaceutical company is cramping the market for the lifesaving medication — all as the overdose death toll continues to rise across New York.
The state has for years stockpiled Narcan, a brand version of a drug called naloxone, which has been approved by the Food and Drug Administration for emergency use since 2015. It can reverse potentially fatal overdoses if administered quickly enough.
The state Department of Health has had a longstanding contract with Emergent Devices, Narcan’s manufacturer, exclusively relying on the company to supply the medication that is then shipped out free of cost to partnering opioid programs across the state.
The partnership has proven lucrative for Maryland-based Emergent Devices — since 2017, the year the first contract was finalized, the health department has shelled out nearly $50 million to the company for its naloxone product.
The state’s most recent contract with Emergent Devices is set to expire Monday, theoretically opening the door for several other pharmaceutical companies who have manufactured competitive versions of the overdose reversal medication. But according to Cadence Acquaviva, a health department spokeswoman, the state will opt to renew its contract with Emergent Devices for another year.
“Narcan is currently the most affordable brand of naloxone that comes in FDA-preferred dosage levels, and it has a longer shelf-life than comparable brands,” Acquaviva said, adding that Emergent Devices could manage the fulfillment order for the entire state of New York.
According to a competitor company, however, the state is stifling the naloxone market by exclusively awarding contracts to Emergent Devices. The London-based Hikma Pharmaceuticals has launched lobbying efforts in New York to persuade the state to consider generic versions of naloxone as well as its own branded naloxone product, arguing that unrestricted access to all versions of the medication will better address the ongoing overdose crisis.
Hikma has retained the well-known lobbying group Bolton-St. Johns to further its cause in Albany, according to public records, including arranging meetings with legislators noted for their work with substance-use issues in order to push its higher-dosage version of naloxone called Kloxxado.
Hikma has made the case that because their product contains more naloxone per dose, the price point remains comparable to Narcan.
Narcan, the most commonly known and used brand of naloxone, comes in 4 milligram doses. Other companies manufacture generic versions of the same spray, including one product from Teva Pharmaceuticals, the prices of which are comparable to Narcan.
Hikma’s Kloxxado product, on the other hand, offers 8 milligrams per dose. The company contends that the more potent medication serves a purpose in a wildly fluctuating illicit drug market where synthetic opioids can come in stronger strains.
“We believe New Yorkers would benefit from the ability to choose from all forms of FDA-approved naloxone, including 8mg intra-nasal Kloxxado, which is a vital part of the lifesaving overdose reversal toolkit, especially when overdoses from widely available illicit forms of fentanyl may require multiple applications of naloxone,” said Steven Weiss, a spokesman for Hikma, in a statement.
Yet some advocates and medical professionals dispute the immediate need for more potent versions of the drug. Stronger doses of an overdose-reversal medication can result in more severe withdrawal symptoms, said Christina Conigliaro, a nurse practitioner who works at the Albany-based opioid program Project Safe Point.
Conigliaro said medical custom when dealing with a potential overdose is to start with smaller doses of naloxone — typically 4 milligrams — and build up, administering more of the medication every few minutes.
Too much naloxone will not ultimately hurt a person, Conigliaro said.
“But you want to give it responsibly and you want to give it effectively,” she said. “A higher dose … might potentially give someone the desire to not use naloxone because that client walks away with the memory of, ‘Hey, that made me feel horrible. I’m not doing that again.'”
Conigliaro said she is waiting to see more medical literature on the need for higher doses when responding to a potential overdose before she starts recommending the product. For now, Project Safe Point is using Narcan, she said.
Public health officials have relied…
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