Hard to believe it has been more than a decade since Chechen rebels took hundreds of Russians hostage in a Moscow theater. Displaying their legendary penchant for tact and patience, Russian special forces pumped the theater full of a gas, the contents of which remain mysterious to this day, developed by the FSB as a "knockout gas." It allowed Russian police to storm the theater and, uh, eliminate the terrorists with traditional Russian ruthlessness, but it happened to kill more than 130 hostages as well. Whoops.
What nobody knew that day – because Russian officials refused to offer any description of the contents of the secret gas for years – was that a major ingredient was fentanyl, a powerful synthetic opiate. High inhaled doses of such a strong drug were fatal for about 15% of the hostages. This was important because if medics and doctors had been told that the hostages had been incapacitated by an opiate drug, they could have saved lives by injecting them with something called an opioid antagonist. When this was finally reported it was the first time I heard of Naloxone.
Apparently Naloxone has become considerably more well known in the intervening years because many states have passed laws recently to relax rules about its administration. This is a result of increased pressure from the public, police, activists, and medical professionals to make Naloxone available for response to opioid overdoses. Briefly leaving aside the inconvenient reality that nobody cared about heroin addicts but now that white kids (and their parents) in the suburbs are ODing on prescription painkillers, it's hard to argue that this is not a good idea.
The problem, as usual, stems from the many glories of the free market and its infinite justice. The sole company in the United States that makes Naloxone noticed around 2008 that demand, driven by government purchases, was starting to soar. So of course they…oh, come on. Do I even need to finish the sentence? Suffice it to say that the drug, the price of which hovered around $3 per dose, became more expensive. By several hundred dollars.
As a generic, technically any manufacturer can start producing it. The problem is that every other drug company knows that at the drug's true price – somewhere closer to $5 per dose – it isn't worth it to invest in starting production. And they are unwilling to take the risk based on the hope that the current attempt at price gouging is sustainable. So the current company, Amphaster Pharmaceuticals, has a de facto monopoly. And oh boy, do they intend to milk it.
The idea of a single payer sends the average American into paroxysms of stroke-inducing rage. The idea of a single supplier, oddly enough, doesn't do the same even when accompanied by a healthy dose of price gouging. With state and local governments essentially at the mercy of the demands of one company for a drug it could hardly give away ten years ago, you'd think someone would be pointing out that the free market is not working as intended. Then you realize that this is in fact exactly how it is intended to work and any confusion disappears.