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State funds for overdose-reversing Narcan run dry, raising prices for municipalities

A dose of Narcan along the "Methadone Mile" in Boston.Jessica Rinaldi/Globe Staff

In Brockton, as in many other cities and towns ravaged by the opioid epidemic, overdoses surge when a lethal strain begins to circulate. That makes a fire department’s inventory of the overdose-reversing drug naloxone — better known as Narcan — invaluable, said one official.

“It saves lives almost every day,” said Brockton Fire Chief Michael F. Williams. “We buy it as we need it. Sometimes we have to buy it more often than we’d like.”

First responders are now facing another grim reality: They are paying more for it, too.

The funding for a state program designed to cut the rate for Narcan purchases for local agencies has run dry, leaving them to pay $71 per box — nearly double the previous price the state had offered. The hike, state officials fear, could stretch already cash-strapped municipal budgets at a time when the drug is still in high demand.


The price jump, according to the Department of Public Health, went into effect in the fall, after funds ran out from a $325,000 settlement that Attorney General Maura Healey’s office had reached with Amphastar Pharmaceuticals in 2015.

That pot of money, combined with a now-depleted $100,000 deposit from the Legislature in 2016, allowed the health department to offer Narcan spray at a subsidized price of $40 per box through the Municipal Naloxone Bulk Purchase Trust Fund.

But now the 140 towns and cities that have used the fund face a price of $71 — a 78 percent jump. That means municipalities could collectively pay tens of thousands more on Narcan purchases through the fund if they continue to buy at the same levels.

“At the same time, DPH is receiving reports of an increase in the number of doses of naloxone [Narcan] needed to revive someone from an overdose due to fentanyl in the illicit opioid supply,” state officials wrote in a report to lawmakers, “which puts additional pressure on municipal budgets.”


The state continues to be in the throes of an opioid epidemic, even if fatal overdoses are finally dropping. The number of confirmed and estimated deaths was 1,977 f0r 2017, down from 2,155 for 2016 — the first such drop since the crisis started five years ago.

But the need for Narcan has not abated. Data that Governor Charlie Baker’s administration released in February showed the number of times Narcan was administrated by providers of emergency medical services in the third quarter of 2017 was the highest for any three-month span since at least the start of 2013.

Healey’s office said it intends to put another $47,000 in settlement money into the fund and encourage the business community to contribute.

“The availability of Naloxone to first responders in our communities is a life-or-death issue,” said Emalie Gainey, a spokeswoman for Healey.

In Brockton, Williams said the Fire Department, which ordered 200 boxes through the fund in fiscal year 2017, also relies on other sources for the drug, including Brockton Hospital.

“Sometimes you can’t fight the drug companies,” he said. “You have to keep an eye on your budget more closely. It’s an impact.”

In a statement, state health officials said that even with the loss of the “temporary discount,” the cost is still lower than the retail price, which can be about $125 per box. They also said they used $578,500 in first-responder grants and put $2.8 million toward the Overdose Education and Naloxone Distribution program to train people on how to administer the drug.


“Massachusetts continues to heavily invest in initiatives to improve access to naloxone throughout the Commonwealth, including for first responders,” the statement said.

A spokesman for the Worcester Police Department, which purchased 175 boxes last year through the fund, said it has been paying the higher rate for Narcan since January. But the department has also relied on a $31,000 grant from the health department, shared with the Worcester Fire Department, to cover the costs.

“Despite the jump in price, every officer will continue to carry Narcan,” Lieutenant Sean Murtha said.

Matt Stout can be reached at matt.stout@globe.com.
Follow him on twitter @mattpstout.