John Cawley

Professor, Cornell Brooks School of Public Policy

John Cawley is a professor of public policy and economics at Cornell University, and director of Cornell in Washington. He says this is an important step, but there will still be a financial cost.

Cawley says:

“Naloxone is, from the perspective of a layperson, a miracle drug that can bring back, from the brink of death, people who’ve overdosed on opiates such as heroin. Allowing it to be sold without a prescription is a critically important step. There are few risks – no one can get high from it and the benefits are potentially enormous.

“Allowing naloxone to be sold over-the-counter (without a prescription) may considerably increase its use. It significantly decreases the time cost of acquiring it. People can soon just buy it at a convenience store, or even order it online for home shipment.

“While making sales over the counter reduces time cost, there is still a financial cost. As always, pharmaceutical prices are a contentious issue involving important tradeoffs. Pharma companies want to earn profits, and as a society we want there to be financial incentives for them to develop new life-saving drugs and ways of delivering them. But we also want those innovations to benefit as many people as possible.

“Emergent BioSolutions hasn’t yet announced what the over the counter version will cost; hopefully it will be low enough to facilitate widespread adoption. However, the government and nonprofits could also consider subsidies to encourage people to purchase and keep naloxone in various locations and on their persons.

“One contrast is the EpiPen: these autoinjectors of epinephrine can save the lives of people who have a severe allergic reaction (anaphylaxis). These remain prescription, however (not OTC), and the brand-name version costs hundreds of dollars, and states are considering laws to limit their price.”