In Baltimore, the health commissioner, Dr. Leana Wen, uses a need-based algorithm to decide which emergency rooms, needle-exchange vans, E.M.T.s and opioid outreach workers receive the city’s limited supply of naloxone — and which don’t. The drug, which reverses overdoses, has saved some 14,000 Baltimore residents since 2015. But its price has increased in recent years, by between 95 and 500 percent, depending on which version of the medication is being considered. Even with donations and discounts from drug makers, Dr. Wen says the city can’t afford all the naloxone it needs.
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