California will buy cheaper naloxone to stop fentanyl deaths

From CalMatters health reporter Ana B. Ibarra:

California can buy more overdose-reversing medication at a lower price under a deal Gov. Gavin Newsom’s office announced Monday with a pharmaceutical company, potentially giving law enforcement, schools and others more resources to address the state’s fentanyl crisis.

Under a government-run pharmaceutical program called CalRx, California will purchase naloxone from New Jersey-based Amneal Pharmaceuticals at a discounted price of $24 for a two-pack of nasal sprays.

This means California can buy about 1.5 times more naloxone for the same price. That’s 3.2 million twin-packs instead of the 2 million twin-packs purchased at the previous price of $41, Newsom’s office announced.

The state purchases the medication and distributes it to schools, law enforcement agencies, county health departments, clinics and community organizations. Residents can obtain naloxone at no cost through one of these public groups. Otherwise, the market price for individuals at a pharmacy is about $50.

Just last week, Amneal Pharmaceuticals announced that it had received approval from the U.S. Food and Drug Administration to sell its nasal spray naloxone over the counter. Amneal’s nasal spray is a generic version of Narcan.

California’s agreement is good for two years and can be extended, according to state health officials. The state expects to order its first units of naloxone from Amneal next month. 

Since 2018, the Naloxone Distribution Project has given out 4.1 million kits of the medication. The state estimates that this has resulted in at least 260,000 overdose reversals. 

• Elizabeth Landsberg, director of the Department of Health Care Access and Information: “By getting this lower price, we are making the financial savings and able to use our dollars to buy more product, which of course is ultimately very much about saving lives.”

In 2022, the latest year for which data is available, 7,385 people died from opioid overdoses; the vast majority of those were related to fentanyl. 

Naloxone is perhaps the most common tool in aiding the opioid and fentanyl epidemic. It is available in the form of a nasal spray, but also in injectable form. It’s largely effective and safe, and California has been pushing for its broader availability in common public spaces, including schools, restaurants and to ride-share drivers. 

“We hope this will become as ubiquitous and as available as other key aspects of first aid kits,” Landsberg said. 

The state’s contract with Amneal is the second one announced under the state’s CalRx initiative, through which the Newsom administration is attempting to make life-saving drugs available below market rate. Newsom announced last year the state would make its own brand of insulin through a contract with Civica Rx. On Monday, Dr. Mark Ghaly, the state’s Health and Human Services secretary, said there is no date yet on when California’s insulin will be available.

A bill to grant more power to California’s attorney general in overseeing acquisitions of health care facilities by hedge funds and private equity firms is bringing out political heavy hitters on both sides — as well as a lot of cash.

As CalMatters Digital Democracy reporter Ryan Sabalow explains, Attorney General Rob Bonta and Assemblymember Jim Wood introduced Assembly Bill 3129 in February, citing the growing trend of “private-equity ownership in the healthcare industry.” According to the bill analysis, between 2013 and 2020, private equity firms acquired 933 physician practices nationwide. Bonta said that these firms maximize profits “at the expense of access, quality and affordability of healthcare for Californians.”

They are backed by groups representing hospital workers, including the state’s physicians’ association, nurses and public employee unions. Combined, these groups and their affiliates have donated more than $3 million to current lawmakers’ campaigns in the past two years. 

But the California Chamber of Commerce and the California Hospital Association oppose the bill. Together, they have donated at least $271,300 to sitting lawmakers in the past two years. The chamber argues that the government shouldn’t have the authority to “unilaterally determine which private transactions are good or bad.” 

For more on the debate, read Ryan’s story.

In other legislative news:

• Civil rights: At its annual lobbying event Monday, the American Civil Liberties Union California drummed up support for Assemblymember Ash Kalra’s bill to reduce police involvement in school disciplinary policies. The measure by the San Jose Democrat would remove existing fines when a school employee does not report certain incidents to law enforcement. The organization is also backing two proposed state constitutional amendments: one to end forced prisoner labor (a proposal that has failed before) and another to recognize housing as a human right.

• Minimum wage: Also Monday, the nonprofit One Fair Wage promoted another measure by Assemblymember Kalra that would require the state’s labor agency to analyze the potential impacts of raising the minimum wage for all California workers. At the state Capitol, the organization urged California lawmakers to raise the minimum to $20 an hour. Kalra’s bill also calls for the labor agency to evaluate the impacts of ending the subminimum wage for prisoners.

South Dakota Gov. Kristi Noem is a rising star, in the conversation as a vice presidential pick for former President Donald Trump. She’s scheduled as a keynote speaker at the California Republican Party spring convention on May 18 ($175 for the luncheon, $300 for a VIP reception). 

But now, she’s in full damage control mode after bragging about shooting her puppy dead. 

That story blew up over the weekend. First, The Guardian reported that in her memoir “No Going Back,” Noem writes that 14-month-old “Cricket” ruined a pheasant hunt, devoured several chickens on her farm and was “untrainable.” So Noem says she took the puppy to a gravel pit and killed her.

Then, some Democratic governors started posting photos of their dogs to troll Noem, with the message: “Post a picture with your dog that doesn’t involve shooting them and throwing them in a gravel pit. I’ll go next.”

Gov. Newsom, who doesn’t miss a chance to bash his Republican peers, wasn’t going to be left out. His version of the post had racked up nearly 600,000 views by Monday.

Noem issued one statement explaining herself, calling the killing a “tough decision” that is part of farm life. “If you want more real, honest, and politically INcorrect stories that’ll have the media gasping, preorder ‘No Going Back,’” she added.

When the controversy didn’t lessen, she issued another statement to defend herself as “a responsible parent, dog owner, and neighbor” who didn’t break any laws.

• Noem, on social media: “Whether running the ranch or in politics, I have never passed on my responsibilities to anyone else to handle. Even if it’s hard and painful.”

But the criticism is continuing: Monday, one host on “The View” called her “Governor Cruella,” a reference to the villain in “101 Dalmatians.”

In other election news: Presidential candidate Robert F. Kennedy Jr. has found a shortcut to California’s November ballot. He created a new party, We the People, but needed at least 73,000 voters to register with it by July 5. 

Monday, Kennedy announced that the American Independent Party, which is already one of the six qualified parties in California, has picked him as its presidential standard bearer. That far-right party’s registration numbers have been inflated by voters who mistakenly believe they are registering as independents.

When does cutting-edge technology collide with domestic violence? In internet-connected vehicles that allow abusers to track their former partners. Find out what may be a solution from CalMatters tech reporter Khari Johnson.