OTC Narcan will arrive next week, at $45 per pack

Emergent BioSolutions has confirmed that its over-the-counter (OTC) version of overdose reversal agent Narcan will be available on the shelves of pharmacies, grocery stores, and gas stations, as well as online, from next week.

Narcan (naloxone) 4 mg nasal spray – which is the most widely-used therapy to rescue people in the throes of an opioid overdose – will be launched in a two-dose pack at a recommended retail price of $44.99, according to the company.

Narcan is already the go-to therapy for emergency personnel and people working to help people with opioid use disorder (OUD), but it is hoped that the availability of the first OTC version of the drug will improve access and help save lives.

The drug was first approved in 2015 and has been available for some time through pharmacies and clinics, with almost all US states allowing branded Narcan or a generic to be dispensed to anyone requesting it without a personal prescription.

However, many pharmacies still don't offer naloxone products, so they don't have to deal with the social issues that accompany opioid misuse, and a recent study indicated that retail pharmacies prescribed only around a third of a total of around 17 million naloxone doses in 2021.

Greater availability via the OTC version could also be important, given the rising number of deaths every year from counterfeit copies of drugs like oxycodone and alprazolam, laced with ultra-strong opioids like fentanyl. While recreational users of these drugs may not consider themselves at risk, having a reversal agent in their medicine cabinet could become a life-saving precautionary measure.

"As a medical professional and mom who experienced the unthinkable and lost both of her sons to accidental overdose, I know you can't put a price on peace of mind and there is no act too great to protect family," said Dr Bonnie Milas, Penn Medicine physician and professor of clinical anaesthesiology and critical care.

"Picking up Narcan nasal spray at the store is not a sign that your family has 'a problem', in fact it shows you are prepared just in case," she added. "It's like buying a fire extinguisher to have at home – having the power to save a life of someone you love, someone you know, or someone that may need another chance."

Last year, approximately every seven minutes one life was lost due to an opioid overdose, and today it is the leading cause of accidental death in the US, said Emergent in a statement.

Some commentators have said, however, that even at the $45 price – around a third of the cost of the prescribed version – those most at risk may be unable to afford it.

The OTC status also applies to generic versions of naloxone 4 mg nasal spray, although, manufacturers of those products have to file for approval to make the switch and update their labelling.