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Why Narcan Is Worth the Extra Purchase Price

Fortunately, many government agencies, caring individual advocates, and non-profit organizations give out Narcan nasal spray for free throughout the United States. As such, most Americans won’t be forced to purchase naloxone as their only way of obtaining the opioid overdose antidote.

Some people will, however. Also, these agencies and non-profits often purchase naloxone as a means of sourcing it for distribution. They afford to make such purchases through grants and donations.

The Average Cost of Generic Naloxone Kits

Generic naloxone comes in vials containing small solutions of naloxone. This liquid is intended for intravenous (IV), intramuscular (IM), or subcutaneous (SC) use, though it’s also fair game for intranasal (IN) administration.

The IV, IM, and SC modes of administration requires syringes along with the vials of naloxone. Intranasal use requires syringes with removable needles replaced with mucosal atomizers, which spray the naloxone in a fine mist suitable for rapid nasal absorption. Some kits also include printed-out instructions for proper naloxone use along with easy-to-follow pictures.

No matter what, each of these four means of administering generic naloxone requires between two and three separate, freely-moving pieces that aren’t as easy to use as one-piece formulations of naloxone, such as Narcan or Evzio.

Narcan nasal spray unit in front of its packaging.
Narcan nasal spray

The United States Food and Drug Administration indicates that the average invoice price of a naloxone kit is $29, on average, here in the U.S. “Average invoice price” refers to the total cost of getting together suitable syringes, naloxone, and instructions for on-the-spot reference.

Name brand Evzio naloxone HCl injection, USP.
Evzio naloxone auto-injector
AP Photo/Cliff Owen

These are more difficult to use than Narcan or Evzio, for example. Many people who administer naloxone are anxious, even to the point of full-blown panic attacks. Simplicity is key insofar as best practices for naloxone administration are concerned.

Naloxone kits, in my experience, are the second-most popular naloxone formulations in Northwest Tennessee and likely elsewhere across the U.S.

The Average Cost of Narcan

Narcan is a name-brand version of naloxone that comes in the form of a nasal spray. The sprayer comes loaded with naloxone and ready for immediate use. It’s also foolproof, unlike generic naloxone kits.

It’s only used intranasally — sprayed into the absorbent mucosal membranes of the nasal cavity — via the nose.

The U.S. FDA reports that the average retail price of Narcan in the United States is $142 per two-unit packages. This equates to $71 per dose.

Narcan is easier to use than naloxone kits. It’s also more widely-known than Evzio or Narcan’s active ingredient itself, naloxone. Also, people are more willing to accept Narcan from active harm reductionists than naloxone kits because kits contain separate syringes.

This is due to the stigma that surrounds the use of syringes for illicit drugs across the United States.

Narcan is, in my experience, the most popular and widely-used version of naloxone in modern NWTN.

The Average Cost of Evzio

Evzio is an auto-injector, name-brand form of naloxone that talks people through the administration process. Evzio is rarely seen in practice due to its exorbitant cost.

The FDA reports that each single-dose unit of Evzio costs $2,321. The average retail price of two-packs of Evzio, in other words, are $4,641.

Out of these three forms of naloxone, it’s the least common by far.

Which One Is the Most Valuable?

Narcan is the most valuable — here’s why:

When people return from being unconscious thanks to opioid overdose, they sometimes have an urge to resist whoever administered whatever form of naloxone was used — in practice, naloxone is naloxone is naloxone, as it all has the same medical effect.

With naloxone kits, people who administer the injectable form of the opioid overdose drug are prone to stabbing themselves, other people who are present, or the person being revived themselves with the syringe that was used during administration.

This can result in the spread of disease and development of infection. Needles could get broken off inside the recipients. The syringes they use also pose much more of a threat than Narcan or Evzio if not properly disposed of.

Evzio may help especially-nervous people through the process of administering naloxone, but it’s simply too expensive for how much value it delivers.

Narcan is roughly between three and five times the average cost of naloxone kits that use injectable, generic vials of naloxone.

However, the value derived from Narcan, which exists on multiple other levels, at this price is simply worthwhile for many buyers of the drug. They can also receive government assistance in paying for naloxone, as well as specifically for name-brand Narcan.

All Considered

At the end of the day, some naloxone is better than none. However, Narcan is a cost-effective formulation that offers several real-world benefits to generic naloxone kits and Evzio.

By Daniel Garrett

I'm a self-employed writer, long-term drug user, and resident of rural Tennessee. Find me on Twitter at @DanielGarrettHR or email me at danpgarr@ut.utm.edu.

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