Narcan can save lives, and out-of-pocket costs are declining
February 15, 2024
Source: Jiang, et al JAMA January 24, 2024 LINK
Last year over 100,000 in the US died of drug overdoses, and over 80,000 of those deaths were due to narcotic overdose. Synthetic fentanyl, cheap to produce, is contaminating many illegal drugs. Fentanyl leads to much more profound respiratory depression than heroin or other narcotics and can sometimes be found in non-narcotic drugs including marijuana or medications used for ADHD. Some who overdose on fentanyl have no idea they even took a narcotic.
Naloxone, the generic of Narcan, became available as a nasal spray in 2021, and has dramatically decreased the cost of making naloxone available. The Food and Drug Administration (FDA)approved the first over the counter (OTC) Narcan product in March, 2023, making this medication available without a prescription. Many workplaces now stock naloxone in their first aid kits, and many individuals have Narcan in their backpacks. Narcan is easy to use (insert into nostril and squeeze) and it is not harmful to administer to someone who is unexpectedly unconscious if they did not have a narcotic overdose,
This is from an email from a WTW colleague:
My son almost died from an accidental overdose on Thanksgiving day. Luckily, I checked on him and recognized the hypoxic breathing and EMTs arrived very quickly. Since then, my daughter has been evangelizing with kids her age about carrying Narcan. A few months ago she had to administer Narcan to a girl at a punk concert. She and her boyfriend gave the girl two doses, dialed 911 and stayed with the girl. She came out of it before the EMTs even arrived.
Here’s a link to a New York Times report last weekend about the devastating toll of overdoses in the construction industry.
The good news is that the cost of carrying Narcan (and the cost of employers adding naloxone to workplace first aid kits) is decreasing.
Implications for employers:
Employers without high deductible health plans (HDHPs) that have tax advantaged health savings accounts (HSAs) can choose to cover naloxone as a preventive medicine with no cost sharing. This drug is not on the list of services that the Internal Revenue Service has indicated can count as preventive services allowed to be covered without cost sharing for HDHPs with tax advantaged HSAs.
Naloxone as part of a workplace first aid kit can save lives. Kits should include at least two doses, the workplace needs to have policies, procedures and training, and naloxone doses should be replaced as they are used or expire.
Employers can design pharmacy plans so that employees have access to all forms of opioid-reversal drugs, including OTC and prescription, to remove any access barriers.
See this post for links to resources for employers from the Surgeon General, the National Institute of Occupational Safety and Health, and the Centers for Disease Control and Prevention.