The state of Florida is paying about $4.5 million more per year on drugs used to provide emergent care in cases of opioid overdose.
At issue is the state’s continued purchasing of the brand name Narcan over a lower-cost generic alternative, naloxone, both emergency opioid antagonist products.
Over the past year, the state has continued purchasing Narcan, a nasal spray used to reverse opioid overdose, at a cost of about $27 per unit, at a rate of up to 1 million units each year, according to images obtained and viewed by Florida Politics. Meanwhile, the equivalent generic naloxone sells for about $4.50 less, at about $22.50 per unit[1].
Both versions utilize the same active ingredient and the same nasal delivery mechanism. Like many generic drugs, the only difference is cost.
Now, the most recent Request for Proposals (RFP[2]) issued to purchase opioid overdose treatment drugs is setting the state up to continue paying more for a product.
At issue is proviso language in appropriations implementation legislation (SB 2500[3]) requiring the state Department of Health to issue an RFP for naloxone through a fair and competitive process that considers both effectiveness and cost, and that includes generic products.
However, the RFP written by the Department of Children and Families (DCF) isn’t following the law. The RFP offers vague scoring criteria to rank proposals, weights drug cost at just 25% of the overall score, and includes requirements only the current supplier, of the brand name Narcan, can meet.
The RFP language effectively blocks lower-cost generics from being considered, even though the generic naloxone has been found to be just as effective as Narcan, and has Food and Drug Administration approval.
The generic naloxone is sold in 4mg units. The RFP as currently written includes a scoring section for that size product, noting that bidders must demonstrate a shipping history of delivering “at least 65,000 units to more than 1,300 enrolled distributors in varying quantities within a single month, at least ten months per year.” Where naloxone becomes immediately disqualified is the next requirement, that “acceptable documentation includes a narrative summary of the shipping history within the past three years.”
Generic naloxone products only entered the market in 2023, meaning it cannot meet the three year requirement.
Complicating the matter, while DCF’s RFP may not directly violate SB 2500, it certainly violates the legislative intent behind the law, including to maximize Florida citizens’ tax burden when purchasing the products.
The RFP does not align with intent related to cost effectiveness, timely availability, or product efficacy. Worse, it fails to meet the Legislature’s intent to consider the use of generic products or establish a competitive bid process, because as written, no generic version can be considered under the current RFP.
The section updated under SB 2500 is housed in Chapter 287[4] of Florida State Statutes, which clearly requires a “fair and open competition” and that “such competition reduces the appearance and opportunity for favoritism.” It also requires the inspiration of “public confidence that contracts are awarded equitably and economically.”
Chapter 287 also enumerates that criteria used for proposal evaluation includes price, including total cost for each year of the contract and renewal years.
At just a 25% weighting, DCF’s RFP for opioid overdose reversal drugs not only fails to prioritize cost, it de-prioritizes it.
The RFP was published in August. It doesn’t close until Dec. 2[5].
References
- ^ $22.50 per unit (calrxnaloxone.com)
- ^ RFP (vendor.myfloridamarketplace.com)
- ^ SB 2500 (www.flsenate.gov)
- ^ Chapter 287 (www.leg.state.fl.us)
- ^ doesn’t close until Dec. 2 (vendor.myfloridamarketplace.com)