Ending the HIV Epidemic Newsletter
NASTAD, in collaboration with the National Association of County and City Health Officials (NACCHO), the Council of State and Territorial Epidemiologists (CSTE), and the National Coalition of STD Directors (NCSD), distributes a monthly newsletter to Phase 1 Ending the HIV Epidemic: A Plan for America (EHE) jurisdictions. The newsletter informs recipients of EHE-related policy updates, communications from federal partners, success stories, and other related EHE information. As the CDC PS19-1906 National Partner and HRSA-20-089 Systems Coordinator Provider recipients, NASTAD also launched an EHE website to house programmatic updates, share strategies and outcomes from Phase 1 jurisdictions, and connect health departments with the community. For questions, comments, or content contributions, please contact Mike Weir.
Hill Happenings
House Republicans Introduce Bill Capping Funds for CDC NCHHSTP in FY2024
On March 29, Representative Andy Biggs (R-AZ-05) introduced H.R. 1962, “to provide for a limitation on availability of funds for Department of Health and Human Services, Centers for Disease Control and Prevention HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention for fiscal year 2024”, which would impose budgetary caps for funding allocated to the Centers for Disease Control and Prevention (CDC) National Center for HIV, Hepatitis, STIs, and TB Prevention (NCHHSTP). The legislation follows through on House Republicans’ commitment to take a hardline approach for FY2024 appropriations negotiations, aiming to impose across-the-board budget cuts. The bill is part of a legislative package that includes budgetary resolutions capping spending for other federal agencies, but it will require approval from the Democrat-controlled Senate in order to become law.
House Republicans Release Debt Ceiling, Government Funding Proposal
On April 19, House Speaker Kevin McCarthy (R-CA-20) released the lower chamber’s proposal to address the looming debt ceiling crisis, which ties raising the debt limit with significant spending cuts in the Fiscal Year 2024 (FY2024) spending bills. The Limit, Save, Grow Act would lift the debt limit by $1.5 trillion or until the end of March 2024, whichever comes first. The Act would also cap FY2024 spending to Congressionally approved spending levels for fiscal year 2022, which would amount to a $4.5 trillion spending cut. To achieve these spending cuts, Congress would slash funding for the Internal Revenue Service (IRS), expand work requirements for certain federal assistance programs like the Supplemental Nutrition Assistance Program (SNAP), and unwind President Biden’s student loan forgiveness program, among other provisions.
President Biden quickly panned the proposal, which is a nonstarter for Democrats, and called on Speaker McCarthy to negotiate in good faith to resolve the debt limit crisis ahead of the mid-August “x date.” The debt ceiling discussions also preclude Congress from advancing FY2024 spending bills until a compromise is achieved, delaying progress on FY2024 appropriations until the late summer or fall. Despite this, House Appropriations Chair Rep. Kay Granger (R-TX-12) is moving ahead with the lower chamber’s budget proposal for FY2024 without input from Democrats, anticipating votes in June. Although Republicans can leverage their majority in the House to advance the package, it will ultimately require Senate approval to become law. NASTAD will continue to monitor the appropriations process and advocate for strong funding for HIV, hepatitis, and drug user health programs in FY2024.
NASTAD Calls on Congress to Pass Reentry Act
On April 17, NASTAD joined 125 organizations and called on Congress to support the Reentry Act, legislation that would allow incarcerated individuals to receive medical services supported by Medicaid thirty days prior to the individual’s release. Currently, the Medicaid inmate exclusion policy (MIEP) prohibits the use of federal funds and services for medical care for inmates of a public institution. This policy prevents Medicaid eligible incarcerated individuals from receiving services funded by Medicaid. The policy also prevents incarcerated veterans from receiving hospital and outpatient care in local jails from the Department of Veterans Affairs. If passed, the bill would make permanent the upcoming Biden Administration guidance allowing states to leverage Medicaid programs to pay for drug treatment in prisons.
Administration Updates
EHE Quarterly Stakeholder Webinar
The Office of Infectious Disease and HIV/AIDS Policy will hold the next quarterly webinar on Wednesday, May 3 from 1:00-2:30 PM ET. The webinar will provide updates on major federal activities related to the implementation of EHE and highlight innovative methods of housing collaborations. To register, please click here (registration is required).
President Biden Signs Bill Ending COVID-19 National Emergency
On April 10, President Biden signed H.J.Res. 7, Relating to a national emergency declared by the President on March 13, 2020. The joint resolution terminates the national emergency related to the COVID-19 pandemic, but does not affect the separate public health emergency (PHE) that is set to expire on May 11. President Biden publicly opposed the Republican-led joint resolution, but declined to veto the legislation after it passed the House and Senate with small but sufficient bipartisan support. Although the termination of the COVID-19 PHE will unwind coverage for COVID testing and remove broad flexibilities for health providers, Congress agreed to temporarily extend Medicaid and Medicare telehealth flexibilities and the Biden Administration will continue to allow remote prescribing of buprenorphine and expanded access to methadone take-home doses while it works to promulgate rulemaking that permanently implements these flexibilities.
Biden Administration Takes Steps to Reverse Ruling that Invalidates ACA Preventive Services Mandate and Clarifies Insurer Requirements Amid Legal Uncertainty
On April 13, the U.S. Department of Justice announced that it will seek a stay of the judgment and order pending appeal for the Braidwood Management Inc. v. Becerra case. The stay would block US District Court Judge O’Connor’s ruling that invalidated the Affordable Care Act’s (ACA) preventive services mandate, preventing it from going into effect as the 5th Circuit Court of Appeals determines the merits of the case. The stay request follows a March 30 filing from the Biden Administration appealing the judge’s ruling, which will make its way through the appellate court and likely be decided by the Supreme Court of the United States.
Additionally, on April 13, the Department of Labor issued guidance clarifying health insurers’ cost-sharing requirements following the Braidwood v Becerra ruling. The guidance confirms that health insurers are legally required to offer any preventive services recommended by the United States Preventive Services Task Force (USPSTF) that were issued prior to 2010 without cost sharing. Additionally, the guidance clarifies that the ruling does not impact cost-sharing requirements for routine immunizations recommended by the CDC Advisory Committee on Immunization Practices (ACIP) or preventive care and screenings for infants, children, adolescents, and women’s health offered through the Health Resources and Services Administration (HRSA). As a result, insurers are still required to cover the full cost of childhood immunizations for hepatitis A virus, hepatitis B virus, and HPV, and contraceptive services, breastfeeding services and supplies, cervical cancer screening, and pediatric preventive care recommended by HRSA.
CDC Launches LGBTQ+ Wellness Webpage Ahead of Summer
The CDC National Center for HIV, Viral Hepatitis, STIs, and TB Prevention (NCHHSTP) launched a new web resource, Get Healthy and Ready for Summer 2023. The webpage includes resources that span across the syndemic of infectious disease transmission and drug overdose, including HIV, viral hepatitis, and STIs. The resource will facilitate greater wellness and health outcomes for LGBTQ+ people as they prepare for summer events and Pride month. The webpage includes widgets with resources for COVID-19, Mpox, and a mental health crisis lifeline.
NIH Study Finds Doxycycline Reduces STIs by Two-Thirds
The oral antibiotic doxycycline prevented the acquisition of sexually transmitted infections (STIs) when tested among men who have sex with men (MSM) and transgender women who took the medication within 72 hours of having condomless sex, according to findings published April 12 in the New England Journal of Medicine. Specifically, the post-exposure approach, termed doxy-PEP, resulted in a two-thirds reduction in the incidence of syphilis, gonorrhea, and chlamydia among the study participants, all of whom reported having an STI within the previous year. However, the research also revealed a slight increase in antibacterial resistance that requires further exploration. The research was funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
CMS Issues Letter to State Medicaid Directors to Improve Care Transitions for Incarcerated Individuals
On April 17, the Centers for Medicare & Medicaid Services (CMS) issued a letter to State Medicaid Directors announcing a new opportunity for states to help increase care for individuals who are incarcerated in the period immediately prior to their release. The new Medicaid Reentry Section 1115 Demonstration Opportunity will allow state Medicaid programs to cover a package of pre-release services for up to 90 days prior to the individual’s expected release date that address various health concerns, including substance use disorders and other chronic health conditions. CMS is encouraging states to leverage the waiver flexibilities implement an innovative service delivery system to facilitate successful reentry transitions for Medicaid-eligible individuals leaving prisons and jails and returning to the community.
CDC, HRSA, HUD Release Dear Colleague Letter Encouraging Action to Prevent and Treat HIV Outbreaks Among People Experiencing Homelessness and Housing Instability
On April 12, CDC, HRSA, and the Department of Housing and Urban Development (HUD) issued a Dear Colleague Letter encouraging communities to take action to effectively prepare for and respond to HIV outbreaks among people experiencing homelessness and housing instability. The federal agencies encourage health department and housing providers to integrate and assess HIV prevention, care, and housing data on individuals impacted by outbreaks to determine the extent to which they are experiencing homelessness or housing instability and to identify gaps and coordinate service delivery to improve housing stability and health outcomes, including leveraging all available resources to establish integrated models of service delivery that meet people where they are. Additionally, CDC, HRSA, and HUD recommend Housing First and other low-barrier housing models that offer flexibility, individualized support, and client choice in the provision of housing assistance and supportive services, including integration with substance use disorder services.
Biden Administration Designates Fentanyl, Xylazine as an Emerging Threat
On April 12, the White House Office of National Drug Control Policy (ONDCP) officially designated fentanyl adulterated with xylazine as an emerging threat to the United States. The Biden Administration issued the designation due to a sharp increase in the presence of xylazine in illicitly sold fentanyl and exacerbated morbidities for people who inject opioids, including fatal overdose and severe wounds. The xylazine emerging threat designation was the first of its kind, authorized by Congress in 2018 via the SUPPORT Act (H.Res.1099) and fleshed out in 2022 ONDCP guidance that delineated the criteria used to declare an emerging threat. Following the announcement, the Administration will launch an interagency working group that will inform the development of a national response plan within 90 days to boost xylazine testing, implement treatment and supportive care protocols, build comprehensive data systems (including information on drug sourcing and supply), propose strategies to reduce illicit supply of xylazine, and conduct rapid research (such as work on the interactions between xylazine and fentanyl). The announcement follows an April 11 statement announcing amplified efforts to disrupt the global illicit fentanyl supply chain.
NASTAD Submits Comment on Updated FDA Blood Donation Restrictions for Gay, Bisexual, and Other Men who have sex with Men
On March 31, NASTAD and the Federal AIDS Policy Partnership (FAPP) submitted comments on the US Food and Drug Administration’s draft Recommendations for Evaluating Donor Eligibility Using Individual Risk-Based Questions to Reduce the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products. The coalition supports the elimination of time-based referrals for gay, bisexual, and other men who have sex with men, but called on the FDA to implement a strategic research plan on PrEP/PEP and blood donation in order to build an evidence base that could inform the removal of blood donation restrictions for gay, bisexual, and other men who have sex with men who take PrEP/PEP.
SAMHSA Funding Opportunity: Substance Use and HIV Prevention Navigator Program for Racial/Ethnic Minorities
The Substance Abuse and Mental Health Services Administration (SAMHSA) is seeking applications under a $10 million funding opportunity to support substance use and HIV prevention services for racial and ethnic minority populations at high-risk for substance use disorders (SUDs) and HIV tranmission. The notice of funding opportunity (NOFO) from SAMHSA’s Center for Substance Abuse Prevention (CSAP) is titled Minority AIDS Initiative: The Substance Use and Human Immunodeficiency Virus Prevention Navigator Program for Racial/Ethnic Minorities.
The NOFO will support up to 34 programs with awards of up to $300,000 per year for up to five years in the 57 jurisdictions prioritized in the Ending the HIV Epidemic in the U.S. initiative. At least two awards will be made to American Indian/Alaska Native tribes or tribal organizations pending sufficient application volume. Applications are due Tuesday, June 20, 2023.
Resources
NHeLP: Future of ACA preventive services requirement uncertain
“The judge who infamously struck down the entire Affordable Care Act (ACA), only to be reversed by the U.S. Supreme Court, this time is targeting the ACA provision requiring most health plans to cover, with no cost sharing, preventive health screenings and services that receive an A or B recommendation from the U.S. Preventive Services Task Force (USPSTF). According to HHS, millions of people have received no cost screenings for various types of cancer, diabetes, and infectious diseases, as well as preventive measures like interventions for persons at risk for cardiovascular disease and medication to prevent HIV infection.”
Health Affairs: Estimated Uncovered Costs For HIV Preexposure Prophylaxis In The US, 2018
“In addition, policies that increase access to health insurance, such as Medicaid expansion, can improve access to PrEP. This may be especially impactful for the southern U.S., where 97 percent of the 2.2 million adults who fall into the Medicaid coverage gap live and which has the lowest PrEP-to-need ratio (the number of PrEP users divided by new HIV diagnoses) in the US.”
NEJM: Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections
“The combined incidence of gonorrhea, chlamydia, and syphilis was lower by two thirds with doxycycline postexposure prophylaxis than with standard care, a finding that supports its use among MSM with recent bacterial STIs.”
JAMA Insights: Antiretroviral Treatment of HIV/AIDS During Pregnancy
“The benefits of ART during pregnancy for people living with HIV include improved maternal and infant health and pregnancy outcomes and reduced perinatal and sexual HIV transmission. With fully suppressive ART initiation prior to pregnancy and maintenance of ART during pregnancy, the risk of perinatal transmission is near zero. Dolutegravir-based ART is among the safest and most effective therapies. Continued long-term surveillance of pregnancy and maternal and child outcomes with use of new antiretrovirals in pregnancy is important.”
“Public health partnerships with businesses and other community partners (e.g., harm reduction programs) might increase hepatitis A vaccination among persons at risk for this infection, while also reducing the stigmatization of hepatitis A-associated risk factors.”
New Podcast Series Available: Health Centers on the Front Lines
TAP-in presents Health Centers on the Front Lines, a 3-part podcast series where we discuss the important role community health centers play in EHE as they bring high-quality, whole-person care to people living with HIV in medically underserved neighborhoods across the country. The podcasts and micro-learning videos feature conversations about:
- Status Neutral Approach
- Long-Acting Injectables
- Improving Access for Black Women
Access the podcasts: https://targethiv.org/tap-in/resources
Join NACCHO’s Subject Matter Expert Advisory Workgroups! HIV, STI, Viral Hepatitis, Harm Reduction, and More!
NACCHO's Subject Matter Expert Advisory Workgroups are a primary and recognized vehicle for identifying the opportunities and challenges facing local health departments (LHDs) and the field at large. NACCHO’s Subject Matter Expert Advisory Workgroups comprise members with expertise in local public health practice. The full list of workgroup descriptions can be found here. The application period will close May 3, 2023.
Workgroup Members:
- Play an integral part in ensuring NACCHO’s policy and advocacy is grounded in the latest science and the day-to-day experience of local health departments
- Connect with peers and other subject matter experts in the field
- Gain exposure to innovative programmatic work at NACCHO and in other local health departments across the country
- Help craft policy statements, shape strategic messaging on key subject matter areas, review tools and Model Practices, and share perspectives on how local health departments are addressing key public health issues.
General questions on NACCHO workgroups can be directed to membership@naccho.org.
NACCHO Releases Two New Funding Opportunities to Evaluate the Integration of STI and Harm Reduction Services
NACCHO is accepting applications for two related funding opportunities to support the evaluation of STI and harm reduction (HR) services. Applicants must already offer integrated STI and HR services. One application is intended to fund organizations that are primarily STI service providers while the other is intended to fund organizations that are primarily HR service providers. Applicants can request up to $50,000 and applications are due Friday, May 12. Access additional information here.
NACCHO Webinar Series on Opioid Settlements and Syndemic Harm Reduction
Every US state is receiving some amount of money from Opioid Settlements. How this money is dispersed and spent varies widely, but in every state and locality there is an opportunity to support harm reduction efforts and local health departments (LHDs) are critical to ensure that evidence-based public health approaches are prioritized. The National Association of County and City Health Officials (NACCHO) is partnering with Community Education Group (CEG) on a 3-part webinar series on Opioid Settlements across the country and how LHDs and their community partners can, and are, leveraging funds to support evidence-based syndemic strategies to reduce harms associated with opioid use and other drugs vulnerable to opioid contamination.
Please join us on Tuesday, May 9th from 2-3pm ET, for an overview of opioid settlements nationwide and how funds may be used to support harm reduction efforts. Please register here.
Two weeks later, on Tuesday, May 23rd from 2-3pm ET, NACCHO and CEG will host the first of three Opioid Settlement Office Hours for LHDs and their harm reduction partners to discuss settlement challenges and receive technical assistance. Please register here.
Please contact jkarr@naccho.org with any questions. Recording will be available to those who register following webinar.
HIV Cluster Detection and Response Learning Collaborative: Apply Now
CAI’s Technical Assistance Provider – innovation network (TAP-in), together with the New York State AIDS Institute’s Center for Quality Improvement and Innovation (CQII), is launching an HIV Cluster Detection and Response Learning Collaborative. This Collaborative aims to improve HIV cluster detection and response efforts to reduce the number of new HIV diagnoses and better link people newly diagnosed with HIV to care. Join other EHE jurisdictions funded by HRSA to participate in a 15-month learning collaborative that will build community partnerships, share lessons learned from other jurisdictions, discover the latest evidence-based practices, and provide strategies for updating HIV cluster and detection plans. For more information and to apply.
CSTE 2023 Annual Conference Registration is Now Open!
Registration for the 2023 CSTE Annual Conference in Salt Lake City, Utah is now open! This year’s Annual Conference will take place June 25-29, 2023. An early bird discount is offered for registrations completed by 11:59 pm EDT on Thursday, May 4, 2023. Click HERE to register for the 2023 Annual Conference!
CSTE Technical Assistance Request Form - EHE Jurisdictions
CSTE, in collaboration with CDC, NASTAD, and Tsuro Consulting, is offering virtual technical assistance to support Ending the HIV Epidemic (EHE) Phase 1 jurisdictions. The aim of this offering is to support EHE jurisdictions seeking assistance with implementing EHE plans. TA topics include data analysis, data visualization, statistical modeling, and data mapping.
For technical assistance, please complete the CSTE Technical Assistance Request Form - EHE Jurisdictions. Please reach out to Symone Richardson with any questions.
CSTE Infectious Disease Peer-to-Peer TA Consultancy Form - HIV
The CSTE Infectious Disease Program is pleased to offer coordination of peer-to-peer technical assistance. CSTE's HIV peer-to-peer technical assistance will be conducted virtually at this time. To give or receive peer-to-peer technical assistance, please complete the CSTE Infectious Disease Peer-to-Peer TA Consultancy Form. If you have any questions regarding HIV peer-to-peer technical assistance, please reach out to Symone Richardson at srichardson@cste.org. If you have any questions about completing the consultancy form, please reach out to Akila Simmons at asimmons@cste.org.
NCSD Resource: Expedited Partner Therapy (EPT) Toolkit
EPT is an evidence-based practice that allows health care providers to treat the sexual partners of patients diagnosed with a sexually transmitted infection (STI), preventing reinfection of the patient. Through EPT, patients can take prescriptions or medications home to their sexual partner(s) who may be unable or unwilling to visit a health care provider.
NCSD Resource: Minor Consent for STI Services
Minor consent policies exist in every state and are an important tool for protecting the safety and well-being of adolescents, families, and communities. When state legislative sessions discuss policy proposals rooted in false narratives about adolescent healthcare, it's important to provide fact-based information on the need for and benefit of the ability of minors to consent for STI testing. This fact sheet includes topline messages, stakeholder resources, and important documentation to support policy makers, agencies, and organizations as they work to safeguard the health of the adolescents, families, and communities they serve.
NCSD STD Engage 2023: Coming Back Stronger
Save the Date for the STD Engage 2023 in person in New Orleans, LA! The event will take place on May 16-18, 2023, with pre-conference events on May 15.
EHE Community of Practice (CoP) on NASTAD’s Online Technical Assistance Platform (OnTAP)
NASTAD and NACCHO manage a virtual Community of Practice (CoP) to support peer-to-peer learning and mentorship for EHE jurisdictions. The EHE CoP is housed on NASTAD’s online technical assistance platform (OnTAP) for those leading their jurisdictions' EHE efforts at local and state health departments to share resources and news, discuss challenges and successes, access notes from monthly EHE Office Hours calls, and request technical assistance (TA). If you need access to OnTAP, please contact Krupa Mehta.
Ending the HIV Epidemic Jurisdictional Directory
NASTAD maintains an Ending the HIV Epidemic (EHE) Jurisdictional Directory. Health department staff members are encouraged to update their jurisdiction’s information using this brief form.
Jurisdictional Map of Phase 1 EHE Final Plans
NASTAD released a resource that provides access to Phase 1 EHE websites and plans. Please email Krupa Mehta additional Phase 1 EHE plans for inclusion in this resource, as well as any changes to existing plans.
Job Postings
Manager, Meetings and Travel – NASTAD
Under general supervision of the Associate Director, IT and Administration, the Manager, Meetings and Travel will provide management, coordination and hands-on delivery of comprehensive service and support to NASTAD members, staff members, and other stakeholders as appropriate. This position will coordinate and implement several, sometimes simultaneous, live, hybrid, and virtual events, particularly to NASTAD’s Annual and Technical Assistance Meetings. This position will monitor airline travel and purchases, manage travel-related vendors, maintain travel-related processes, reconcile meeting and travel expenses, complete appropriate forms and procedure documents, and work to fulfill NASTAD mission, goals, and objectives within the limitations of agency resources and policies and federal grant requirements.
Manager, Health Systems Integration (Data Integration) – NASTAD
The Manager, as part of the Health Systems Integration team, provides support on population health informatics and data linkage processes, focusing on HIV surveillance data and health care data systems, including Medicaid claims databases. The Manager will support NASTAD’s population health informatics portfolio, supporting robust technical assistance support in the area of data systems integration and serves as a resource to health departments seeking to integrate disparate data sources.
Senior Director, Health Equity – NASTAD
The Senior Director is responsible for the strategic leadership, direction, and results of NASTAD’s internal and external health equity, anti-racism, and anti-stigma activities; leading the “Health Equity” priority of NASTAD’s strategic plan. The Senior Director, of Health Equity, is responsible for developing and implementing training and professional development regarding these cross-cutting issues. The Senior Director, Health Equity supervises the work of NASTAD staff on the Health Equity Team. Additionally, the Senior Director, of Health Equity’s role includes leading NASTAD’s member services activities to enhance member engagement. The Senior Director, of Health Equity, frequently interacts with NASTAD members, partners, and federal agencies. The position upholds and advances NASTAD’s values, mission, and priority goals and objectives with an understanding of the organization’s resources and policies, and grant requirements. This position is defined within the Public Health Programs Specialists family.
News Bulletin
Top Democrats ask health insurers for response to ObamaCare preventive care ruling
“Democrats in key House and Senate health committees have requested information from a dozen major health insurance companies and trade groups on how they plan to respond to the ruling from Texas that struck down the preventive services provision in the Affordable Care Act. The lawmakers sent out letters to major insurance providers including Blue Cross Blue Shield, Cigna, Humana and UnitedHealth Group. The letters asked whether consumers would experience interruptions in their coverage in light of the ruling issued by U.S District Judge Reed O’Connor last month.”
STDs are at record levels. It could get much worse.
“White House officials fear that the most recent legal blow to the Affordable Care Act could undermine more than a decade of national progress on HIV and worsen record-high rates of sexually transmitted diseases. U.S. District Court Judge Reed O’Connor’s decision last week tossed out the requirements for insurance companies to cover the HIV prevention drug PrEP and to offer a range of preventive services — from syphilis tests to depression screenings — at no cost. And while the Biden administration is appealing the ruling, many worry it won’t fare any better before conservative-leaning judges in the higher courts.”
Biden announces Medicaid, ObamaCare access for DACA recipients
“The Biden administration on Thursday rolled out a plan to expand health care access for beneficiaries of Deferred Action for Childhood Arrivals (DACA). Under the plan, DACA recipients will become eligible to apply for Medicaid and to enroll in Affordable Care Act (ACA) insurance exchanges. DACA beneficiaries are not currently eligible for those benefits because their immigration status does not meet the current definition of “lawful presence” required to enroll in Medicaid and the ObamaCare exchanges. Under the administration’s plan, the Department of Health and Human Services (HHS) is preparing a new rule to amend that definition by the end of the month.”
Why more states are decriminalizing fentanyl test strips
“More red states are moving to decriminalize test strips used to detect fentanyl in illicit or counterfeit drugs as the substance becomes a leading killer of adults under 50. The paper strips can reduce fatal overdoses, especially in instances when people unknowingly consume fentanyl-laced pills that look like prescription drugs…Until recently, many states viewed the strips as drug paraphernalia that could embolden people to use substances shown to be free of fentanyl. That stance is at odds with harm reduction advocates, the American Medical Association and the Biden administration.”
Emergent aims to price over-the-counter Narcan at about $50
“Contract drugmaker Emergent BioSolutions Inc said on Thursday it is aiming to price the over-the-counter (OTC) version of its opioid overdose reversal drug Narcan at around $50 per carton. The OTC version will become available at U.S. stores and online retailers later this summer, while the currently available prescription nasal spray carries a wholesale price tag of $125 per carton. Emergent's statement comes nearly a month after the U.S. Food and Drug Administration allowed Narcan to be sold over-the-counter, allowing for easier availability of the life-saving medication. The approval paved the way for expanded access to the drug in areas that have concentrated overdose problems and a few pharmacies, but uncertainty remains around Narcan's final price and whether insurers will offer coverage. Emergent has not disclosed the final price for OTC Narcan yet.”