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August 2017

Blue Cross, Blue Care Network no longer cover Evzio®, effective Sept. 1

To provide appropriate therapy and affordable prescription drug benefits, Blue Cross Blue Shield of Michigan and Blue Care Network commercial (non-Medicare) plans will no longer cover the Evzio injection, effective Sept. 1, 2017.

Naloxone, the active ingredient in Evzio, is used to reverse the effects of an opioid overdose until emergency medical care can be given. Blue Cross and BCN will continue to provide coverage for more cost-effective alternative naloxone products that provide the same treatment.

The following table includes additional information about Evzio and the covered alternatives.

Available naloxone products

Drug

Strength and formulation

Average cost**
(per 2 doses)

Cost to the member as of Sept. 1, 2017

Evzio

0.4mg/0.4mL and 2mg/0.4mL injection

$4,900

Full cost
(not covered)

Narcan®

4mg nasal spray

$150

Preferred brand copay

Naloxone

0.4mg/mL and 1mg/mL injection
(vial and syringe)

$50

Generic copay

**Cost for drug based on the average wholesale price.

If you’ve been prescribing Evzio, please discuss the covered alternatives with your patients.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2016 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.