BCBS of Massachusetts to Cover OTC Narcan Nasal Spray


Nonprescription Narcan will be available beginning in September in pharmacies and grocery stores, as well as online retailers and have a suggested cost of $44.99.

Blue Cross Blue Shield of Massachusetts will cover, with no cost share to members in Massachusetts, the nonprescription Narcan to treat opioid overdose emergency.

Sandhya Rao, M.D.

Sandhya Rao, M.D.

“Waiving out-of-pocket costs for this emergency medication aligns with our commitment to ensuring our members have access to the substance use disorder treatment they need, when they need it – especially critical as opioid-related overdose deaths in Massachusetts continue to rise,” Sandhya Rao, M.D., Blue Cross' chief medical officer, said in a press release.

Opioid deaths continue to rise. From 2020 to 2021, opioid deaths rose 15%, according to CDC. More than 75% of the drug overdose deaths in 2021 involved an opioid. The FDA approved Narcan OTC (4 mg naloxone nasal spray) in March 2023, and its manufacturer, Emergent BioSolutions, has said it will be available on shelves nationwide and online beginning in September with a suggested retail price of $44.99 for a package of two.

Narcan nasal spray was first approved by the FDA in 2015. According to the agency’s process to change the status of a drug from prescription to nonprescription, the manufacturer provided data demonstrating that the drug is safe and effective for use as directed in its proposed labeling.

The application to approve Narcan nasal spray for OTC use was granted priority review status and was the subject of an advisory committee meeting in February 2023, where committee members voted unanimously to recommend it be approved for marketing without a prescription.

Emergent BioSolutions has also lowered its “public interest price,” what it charges schools, local governments and community organizations, to $41 for two-dose carton effective Aug. 31, 2023.

Related: FDA Approves Second Over the Counter Naloxone Nasal Spray

A second nonprescription naloxone nasal spray, ReVive 3.0 mg, was approved in July 2023 and should be available in early 2024. Harm Reduction Therapeutics said it will supply RiVive free to communities that need it most and will make at least 200,000 doses available for with no charge. Company executives said the company will not profit from the product.

Michael Hufford, Ph.D., co-founder & CEO of Harm Reduction, told Formulary Watch last month that it costs $36 to manufacture and package each twin pack of RiVive. “That price also allows us to give 10% of our inventory away free (approximately 100,000 twin packs in year 1),” he said. “As partners step forward with charitable donations, that will enable us to reduce the cost of RiVive, and/or give more of it away for free.”

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