EVZIO or Pre-Emptive Naloxone with Opioid Rx?

[rexed]

Just had a visit with the Evzio rep, obviously promoting co-rx Naloxone with any Opioid Rx. Was wondering what the groups stance has been on giving Naloxone with all opioid Rx? I guess it can go along with the concurrent Movantik rx that the reps promote as well?

I've never co-rx Naloxone with any opioid rx in the past, just wondering if there's a liability question at hand?

TIA,
Rex

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[lobelsteve]

1. Mandatory over 90meq.
2. Recommended over 50 meq.
3. No reason not to for any meq.

Can use other products as well. Evzio is free with commercial insurance via their rx program.

 

[pastafan]

Evzio incredibly expensive and thus your profile with insurers may make you less desirable. Generic naloxone plus nasal delivery device as good and cheap. I believe in some states pharmacies provide for free w/o prescription.

 

[Ducttape]

agree with steve.

products like Evzio do nothing to help with the overall cost of healthcare, but if that is what is affordable to the patient, then id prescribe.

fyi, I disagree with Movantik. taper is the best policy for OIC that is not being used for cancer pain.

 

[cowboydoc]

1. Mandatory over 90meq.
2. Recommended over 50 meq.
3. No reason not to for any meq.

Can use other products as well. Evzio is free with commercial insurance via their rx program.

My hospital just rolled out rules for PCPs with this exact rule at 50 and 90 meq.

What real repercussions are you all experiencing for prescribing expensive drugs? Most of my rxes are cheap, but I use a lot of Pennsaid with a deal for max $10 out of pocket coupon. Good for patient, at least in short run, probably not the insurance co.

 

[Tapspatellas]

1. Mandatory over 90meq.
2. Recommended over 50 meq.
3. No reason not to for any meq.

Can use other products as well. Evzio is free with commercial insurance via their rx program.

I'd also add that I consider mandatory if lung pathology, OSA, or any benzo use that isn't weaned.

 

[Orin]

Agree with doing it for high dose (defined as you will), high risk med combos, high risk medical issues, and anyone with kids.

I prefer naloxone vials/syringes and/or the nasal sprays due to the cost with Evzio. They seem to be pulling a similar racquet to the Epipen folks

 

[bedrock]

How exactly does one write the script for the generic naloxne nasal spray, I.e the exact phrasing of the script?

 

[pastafan]

How exactly does one write the script for the generic naloxne nasal spray, I.e the exact phrasing of the script?

http://www.prescribetoprevent.org/wp-content/uploads/2012/11/naloxone-one-pager-in-nov-2012.pdf

https://prescribetoprevent.files.wo...escribetoprevent_-_naloxone_instructions1.pdf

 

[lobelsteve]

http://www.prescribetoprevent.org/wp-content/uploads/2012/11/naloxone-one-pager-in-nov-2012.pdf

https://prescribetoprevent.files.wo...escribetoprevent_-_naloxone_instructions1.pdf

From the link: 99408 = G0396 and it pays 0.65 wrvu.

 

[Tapspatellas]

http://www.prescribetoprevent.org/wp-content/uploads/2012/11/naloxone-one-pager-in-nov-2012.pdf

https://prescribetoprevent.files.wo...escribetoprevent_-_naloxone_instructions1.pdf

I provide a handout to my patients from the prescribe to prevent website. I will mention that the pharmacists where I am located all carry different strengths, solutions and sizes of narcan, and my staff is constantly getting calls from them asking for a different rx, so potentially be prepared if not an rx of evzio (which I almost never rx because of cost and coverage, but I would prefer)