OTC Narcan will be available without prescription

For the first time, people across the US will be able to purchase an overdose-reversal drug that’s as easy to administer as Flonase, without a prescription.

Next week, nationwide chains like Walgreens, CVS, Walmart, and Rite Aid will begin selling two-dose boxes of Narcan, a naloxone nasal spray that saves people from opioid overdose, in stores and online.

Making naloxone widely accessible has long been a goal for public health experts because Fentanyl-laced drugs can kill people before paramedics arrive, but some now worry that over-the-counter Narcan’s $45 retail price could be too high for those who need it most.

That’s where insurance (kind of) comes in:

  • Medicaid and Medicare already cover prescription naloxone, and so far, Missouri, California, Massachusetts, Washington, Rhode Island, and Oregon Medicaid programs said they’ll cover OTC Narcan, too.
  • While private health plans often restrict OTC drug coverage, Blue Cross Blue Shield of Massachusetts said it’ll fully cover nonprescription Narcan.

But this won’t help the one-fifth of people with opioid use disorder who are uninsured. Some government and harm reduction programs give out Narcan for free—and those groups can now order two-dose boxes in bulk at a discounted $41 per box, according to manufacturer Emergent BioSolutions.

Other options include…a prescription-only naloxone generic by Teva Pharmaceuticals, which is widely available for less than $10 out of pocket. And another OTC version, RiVive, will head to stores early next year and is expected to cost less than Narcan.