Expert Pharmac committee recommends funding for overdose reversal nasal spray

Public funding for a lifesaving opioid overdose reversal nasal spray is one step closer, with an expert committee saying that funding the medicine for use by non-paramedic first responders and people at high risk of an opioid overdose is a high priority.

Drug Foundation Executive Director Sarah Helm says the recommendation from Pharmac’s Pharmacology and Therapeutics Advisory Committee (PTAC) to fund nasal spray naloxone (sold in New Zealand as Nyxoid) is a huge step forward in the years-long struggle to improve access, but that it’s now up to Pharmac to prioritise funding for the medicine.

“Naloxone saves lives, and we urgently need to get it into the hands of the community,” she says.

“We know that there are a lot of demands on Pharmac’s budget, but thankfully the cost of funding this medicine is relatively low. We are hopeful that they can approve funding as soon as possible.”

Nyxoid is currently available to purchase over the counter in New Zealand, but is prohibitively expensive at $105 for a pack of two.

Helm says that opioids were implicated in almost half of all fatal overdoses between 2017 and 2021, and the increase in powerful new synthetic opioids like nitazenes being sold as other drugs means that the risk of overdose is growing.

“We don’t just need this medicine out there to reverse overdoses happening today, but to ensure we’re prepared in the event of a mass adulteration of our drug supply, which is only becoming more likely,” says Helm.

“We’ve had a recent win with Pharmac making injectable naloxone available through needle exchanges, but funding for a nasal spray that can easily be used by the general public would be an absolute game changer.”

PTAC provides objective clinical advice to help Pharmac make funding decisions.

The committee recommended that a nasal spray version of naloxone should be funded for first responders like police and firefighters, and suggested that a take home naloxone (THN) programme could be piloted to freely distribute nasal spray naloxone to people who are at risk of an opioid overdose.

A similar THN pilot in Australia was estimated to have saved up to three lives a day between 2019 and 2021. The success of that pilot led to the country funding a permanent THN scheme in 2022.