A remarkable thing happened in 2008: drug overdose surpassed auto fatalities as the leading cause of accidental death in the United States. Public health officials declared an epidemic, and communities united to battle this new enemy that had left a staggering body count in its wake. The people had a weapon, naloxone, an antidote that reverses opiate overdose, and programs began popping up across the country to provide training and free naloxone to people at risk for overdose. But then Big Pharma stepped in. The same year that naloxone became so critical to saving lives, one pharmaceutical company secured a monopoly on its production and jacked up the prices by 1,100%.

The company, Hospira, claims its monopoly on injectable naloxone was unintentional. Naloxone has enjoyed price competition from manufacturers since it first came on the market in the 1960s, but in the early 2000s manufacturers began closing production lines without explanation. Hospira became the sole producer of injectable naloxone by default – a position it still holds today as no new manufacturers have stepped into the market. Generic, sterile injectables like naloxone can be difficult and costly to produce, and low return on investment is likely a deterrent to new manufacturers.

Whether Hospira maintains its grip on naloxone due to natural market forces or deliberate attempts to monopolize a product of increasing value to our over-prescribed nation, the price increases have been detrimental to overdose prevention programs. When costs blew up in 2008, threatening the sustainability of one of the largest naloxone distribution centers in the country, the Chicago Recovery Alliance, director Dan Bigg called Hospira to plead for a price break.

“One of Hospira’s marketing executives explained the rationale behind the increase,” says Bigg. “He told me that Hospira wanted to increase the average customer bill by 3-4%. Instead of raising all their prices and risk losing customers to the competition, they combed through their list of products and chose one item for a price increase so high as to cause the average bill to go up 3-4%.”

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