A temperature-stable naloxone and intramuscular delivery device that makes an inadvertent needle stick virtually impossible has been developed. Recently, this device, called Evzio, received FDA approval.

According to representatives of Kaléo, which makes Evzio, pricing has not been fully worked out, and there will likely be volume and institutional discounts. However, according to a New York Times article, the cost could be in the hundreds of dollars for each device.⁴

Sustainability

Lastly, how are first responders going to get reimbursed for medication replacement? They do not typically bill insurers or patients, and regardless, many of these patients do not have any coverage or the ability to pay.

Best Practices

With all advances come potential difficulties. Naloxone administration has the potential to save many lives. It is important to realize the potential unintended consequences so that first responders develop a program that is safe to the patient and provider, effective, and sustainable.

Dr. Kivela is managing partner at Napa Valley Emergency Medical Group, medical director of Medic Ambulance, and part owner of Elan Medical Corporation. He is Vice President of the ACEP Board of Directors.

References

1. Ogbur O. Naloxone–hydrochloride injection (Narcan, Evzio). MedicineNet. Available at http://www.medicinenet.com/naloxone-injection/article.htm. Accessed Jan. 5, 2015.
2. World Health Organization. Accelerated stability studies of widely used pharmaceutical substances under simulated tropical conditions. Available at http://apps.who.int/medicinedocs/es/d/Jh1808e. Accessed Jan. 5, 2015.
3. Naloxone. PDR Network. Available at http://www.pdr.net/drug-summary/naloxone-hydrochloride?druglabelid=777. Accessed Jan. 5, 2015.
4. Rosenthal E. For drugs that save lives, a steep cost. The New York Times. April 27, 2014. SR4.