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‘Stare oF New York (Orrice oF THE ATTORNEY GENERAL 120 BROADWAY New York, NY 10271 nic T. Scwweipeanans 21) 416-2080, Arroener Goin December 1, 2014 SUBMITTED VIA FACSIMILE AND MAIL Jack ¥. Zhang, Ph.D Chief Executive Officer Amphastar Pharmaceutical, Ine. 11570 6th Street Rancho Cucamonga, California 91730 Fax: 909-982-5728 Dear Dr. Zhang: I write to express my deep and growing concern with the sharp escalation in prices for your ‘company’s version of the heroin antidote naloxone. To date, Amphastar Pharmaceuticals has led to provide any satisfactory explanation for dramatically increasing the pice ofa critical, lifesaving drug during the midst ofa public health emergency. In urban and rural communities across the United States, the anguish associated with heroin ‘overdoses continues to mount. Over the last decade, there has been a ten-fold increase in overdose-related deatis nationwide, fueled largely by heroin and other opioids. Last year, ‘overdoses caused by heroin and other opioids claimed the lives of 602 people in New York City alone. By dispensing naloxone through a nasal inhaler, first responders can safely and effectively reverse a heroin or opioid-related overdose—saving the life ofthe person experiencirg an overdose and offering hope to families seeking to steer addicts into treatment programs. This potential to save lives ed my office to establish the Community Overdose Prevention (“COP”) rogram in April 2014, ‘The COP program equips police departments statewide with naloxone and funds trang in how to.administer it, To dete, we have approved funding for 28,343 kits and associated training, ‘representing more than $1.9 milion to 175 departments and agencies in New York. As similar programs ramp up natonwide, we expect the number of lives saved to continue to increase. Unsurprisingly, naloxone has become an apparent profit center for Amphastar, a highlighted in the company’s last quarterly report. Infact, Amphastar reported that the su2cess of naloxone offer lower sales of other products. With no explanation or warning, Amphastar nonetheless chose to inflate its prices. One report indicates that wholesale prices fora dose of naloxone rose from $13 to more than $30, representing a 131% jump. This is consistent with data collected through tke COP program; in Just afew months, the costs to New York law enforcement have more than doubled. A dose of | ‘naloxone that a participating police department had purchased for $14.90 in August is now selling for $54.50, Similarly a naloxone kit that another department had purchased for $54 in ‘September is now retailing for $109. Barring greater transparency into the rationale for these price increases, the decision by Amphasar to increase prices is unacceptable. These increases threaten to curtail access toa drug just when its needed most. As the holiday season nears, drug overdoses are expected to surge— ‘making the price increase especially problematic now. Given that public agencies constitute major purchasers of naloxone and the far-reaching ramifications for public health itis difficult to understand your company's decision to more than.

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