Applewhite and Sherman Respond

[...]some participants in our pilot project requested intranasal naloxone during our follow-up phone calls.[...]the first Food and Drug Administration-approved intranasal version of naloxone, Narcan nasal spray, which was approved during our pilot project, costs $75 dollars even at its reduced rate for nonprofits.1 Even more expensive is Evzio, an autoinjector formulation of naloxone that costs over $4000, reflecting a 500% price increase over a two-year period.2 We have weighed the costs and benefits of different naloxone formulations and have decided to continue to use injectable naloxone so that we can meet the high demand of the community.Susan G. Sherman is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Correspondence should be sent to Dinah P. Applewhite, c/o Internal Medicine Residency Program, Massachusetts General Hospital, 55 Fruit St, Gray 7-730, Boston, MA 02114 (e-mail: dapplewhite@partners.org).