Presenting author: Eliza Wheeler
Presenting author biography:
Since 2001, Eliza has been involved in harm reduction projects including syringe access/naloxone distribution, drug checking and emergency shelter. In 2022, she co-founded Remedy Alliance, a non-profit wholesale naloxone distributor focused on ensuring that harm reduction programs have access to low-cost and free naloxone for distribution in their communities.
Remedy Alliance: How an informal buyers club solved a naloxone access problem for harm reduction programs
Maya Doe-Simkins, Eliza Wheeler, Nabarun Dasgupta
In the United States since 2012, the backbone of community-based naloxone access has been the unincorporated, unfunded Naloxone Buyers Club, which facilitated purchase of low-cost injectable naloxone by harm reduction programs. In 2021, a manufacturing problem caused an affordable naloxone shortage for the Buyers Club. This crisis forced a revision of the Buyers Club and transformation into Remedy Alliance/For The People in August, 2022.
Remedy Alliance capitalized on existing relationships with harm reduction programs, negotiated special pricing with naloxone manufacturers, and applied an exemption to the FDA’s Drug Supply Chain Security Act to launch operations as an exempt wholesale naloxone distributor.
This unique model effectively removes barriers that harm reduction programs experience as a result of naloxone’s prescription-only status.- One quarter of Remedy Alliance’s customers were previously unable to purchase naloxone. Remedy Alliance’s tiered pricing allows inadequately funded (41% of customers) and unfunded (28% of customers) programs access to cheap and free naloxone while offering sufficiently funded programs (31% of customers) access to below market-rate naloxone.
To access Remedy Alliance naloxone, programs submit an easy application which is only open to programs giving a majority of naloxone directly to PWUD for free in a low-threshold manner. This new model is sustainable, relies only minimally on grant funding, is by and for harm reduction programs, represents ownership of mechanisms of naloxone distribution, and prevents diversion of taxpayer resources to for-profit companies that have no track record of reinvesting in harm reduction or public health.
In the first two months of operations, Remedy Alliance has shipped more than 275,000 naloxone doses to 36 states. Forty percent of naloxone orders were for free naloxone.
Remedy Alliance is a replicable model that could be trialed in countries beyond the United States.