Last week, President Trump suggested that he would finally declare the opioid epidemic a national emergency, a claim he has made before.
Of course, this would be a good first step, and something the President’s own Commission on Combating Drug Addiction and the Opioid Crisis recommended he do back in July.
But the President’s Opioid Commission also made a much more important recommendation—allow the government to negotiate lower prices for the life-saving drug naloxone.
Last month, I led 50 of my House colleagues, including Maryland Representatives Jamie Raskin, Dutch Ruppersberger and John Sarbanes, in urging President Trump to negotiate lower prices for naloxone. However, we have yet to receive a response from the President.
This is inexplicable, since his Opioid Commission explicitly advised the President to “declare a national emergency” and “immediately negotiate lower prices to get the lifesaving drug, naloxone, into the hands of law enforcement and first responders across the country.”
Naloxone is a non-addictive and safe drug used by first responders across the country to reverse the effects of heroin and other opioid overdoses. It is an essential tool in saving American lives.
About 64,000 Americans perished from drug overdoses last year in this rapidly worsening national crisis. The White House’s delay in acting on our plea—and the advice of its own panel of experts—is unacceptable.
Here in Maryland, state health officials recently reported that 2,089 people fatally overdosed in 2016, up 66 percent from 2015. About a third of these deaths, 694, were in Baltimore.
Naloxone has become a key part of our emergency response to the skyrocketing fatalities from opioids (which now include prescription painkillers, heroin, and fentanyl, a powerful drug commonly mixed into heroin). The goal is to keep opioid users alive long enough to get them into treatment.
Public health experts advise that expanding the availability of naloxone is not the only reform needed to respond to this burgeoning public health crisis. Nevertheless, it also is clear that, as public officials work to control and ultimately reverse this opioid epidemic, expanded availability of naloxone at a more reasonable cost would save more lives.
Federal negotiations focused on achieving the recommendation of the President’s Commission would allow us to get more of our opioid dependent neighbors into drug treatment and, thereby, lower the human, public health, and public safety costs associated with America’s hemorrhaging opioid epidemic.
Factors beyond the cost of naloxone are limiting its use, including the stigmatization associated with opioid use and lack of familiarity with the treatment among clinicians and opioid users. Nevertheless, we know that the cost of this life-saving drug is placing a severe burden on public health officials.
Here in Baltimore, Dr. Lena Wen, Baltimore City’s Health Commissioner, observed last summer that demand for naloxone has jumped significantly amid the drug epidemic and that the City’s Health Department needs expanded funding for more supplies.
“We are rationing,” Dr. Wen has acknowledged. “We’re deciding who is at the highest risk and giving it to them.”
Here is the budgetary challenge: Various formulations of the life-saving drug have increased by more than 100 percent in recent years. An easier-to-use, two-dose formulation by Evzio was priced at $690 when it was introduced in 2014. It costs a staggering $4,500 today, an increase of more than 500 percent in two years.
There are a number of public policy strategies the Trump Administration could pursue in meeting this budgetary challenge.
The most straightforward would be for the federal government to negotiate with naloxone manufacturers to provide a better price for the drug for all government agencies. In return, manufacturers would benefit from increased sales volumes, since state and local officials would finally be able to afford the naloxone they need.
Whatever approach the Trump Administration and Congress pursue, we must respond to the harsh reality that opioid overdoses are killing Americans at an unacceptable and unsustainable rate.
On October 30, beginning at 10:00 A.M., I will be joining former President Bill Clinton, Dean Ellen MacKenzie, and other world-class experts at The Johns Hopkins Bloomberg School of Public Health. We will be coming together to share our understanding about how our nation can better respond to this opioid epidemic jhsph.edu/OpioidSummit/webcast/.
I intend to ask for the medical community’s engagement in convincing the President to act. We must instill a heightened sense of urgency in the White House, I will say to them.
The carnage from our national opioid epidemic is expanding exponentially – and the American people deserve an urgent and more effective federal response.
Congressman Elijah Cummings represents Maryland’s 7th Congressional District in the United States House of Representatives.