Third time's the charm: Adamis nabs ap­proval of high-dose nalox­one in­jec­tion af­ter two CRLs

If at first you don’t suc­ceed, and at sec­ond you don’t suc­ceed, try, try again.

That’s been the un­of­fi­cial mantra for Adamis Phar­ma­ceu­ti­cals’ high dose nalox­one in­jec­tion, which re­ceived two CRLs in the span of a year be­tween the No­vem­bers of 2019 and 2020. But on Mon­day, word came through that the FDA ap­proved the drug on Adamis’ third at­tempt, giv­ing doc­tors an­oth­er tool to treat in­di­vid­u­als who over­dose on opi­oids.

The drug will be mar­ket­ed as Zimhi, and there’s no word yet on the price. An Adamis spokesper­son told End­points News via email that the drug will be priced by US WorldMeds which will set it “com­pet­i­tive­ly.”

“The high­er in­tra­mus­cu­lar dos­es of nalox­one in ZIMHI should re­sult in more rapid and high­er lev­els of nalox­one in the sys­temic cir­cu­la­tion, which in turn, should re­sult in more suc­cess­ful re­sus­ci­ta­tions,” said Jef­frey Galinkin, for­mer FDA ad­comm mem­ber and paid Adamis con­sul­tant, in a pre­pared state­ment. He added the drug will par­tic­u­lar­ly help the ris­ing num­ber of fen­tanyl-re­lat­ed over­dos­es.

In­vestors wel­comed the news for the small-cap play­er, send­ing Adamis shares $ADMP up 17% in ear­ly Mon­day trad­ing to $1.33 per share. The stock price has yet to re­cov­er from a Feb­ru­ary 2019 re­jec­tion, how­ev­er, when reg­u­la­tors shot down a pitch for an erec­tile dys­func­tion drug.

Nalox­one, gen­er­al­ly sold un­der the brand name Nar­can, has proven a key el­e­ment to try­ing to curb the opi­oid epi­dem­ic in the US, be­ing used by first re­spon­ders and emer­gency room doc­tors to im­me­di­ate­ly in­ter­vene dur­ing an over­dose. De­vel­oped by Adapt Phar­ma and now owned by Emer­gent BioSo­lu­tions, Nar­can is avail­able at a 40% dis­count to state and lo­cal gov­ern­ments and non-prof­it or­ga­ni­za­tions.

Adamis, mean­while, cen­ters its strat­e­gy on of­fer­ing low­er-cost al­ter­na­tives to drugs that are al­ready out there. Nar­can and oth­er nalox­one-based prod­ucts like Evzio gen­er­al­ly use less of the drug than Zimhi’s 5 mg/0.5 mL dose.

For Zimhi, the biotech ran in­to man­u­fac­tur­ing head­winds both times it re­ceived re­jec­tions, but the FDA has os­ten­si­bly been sat­is­fied with the com­pa­ny’s reme­dies. Pri­or to the sec­ond CRL, Adamis had en­tered in­to a dis­tri­b­u­tion agree­ment for the pro­gram that would have, pend­ing ap­proval, to­taled up to $26 mil­lion in up­front cash and mile­stone pay­ments. It’s un­clear whether that agree­ment will take ef­fect with Mon­day’s news.

Adamis’ main prod­uct is an ep­i­neph­rine in­jectable called Sym­jepi, which is used to treat al­ler­gic re­ac­tions and ana­phy­lac­tic shock sim­i­lar to My­lan’s block­buster EpiPen. Re­searchers for­mu­lat­ed a way to use the same de­liv­ery sys­tem for Zimhi as Sym­jepi, and the biotech is al­so de­vel­op­ing treat­ments for a range of res­pi­ra­to­ry dis­eases, such as Covid-19, in­fluen­za, asth­ma and COPD.

Pre­vi­ous­ly, the FDA had al­so ap­proved a gener­ic ver­sion of Nar­can nasal spray to be used by those with­out med­ical train­ing in April 2019.

This ar­ti­cle has been up­dat­ed to in­clude Zimhi pric­ing in­for­ma­tion and to clar­i­fy that Jef­frey Galinkin is a paid con­sul­tant for Adamis.

Image courtesy of The Janssen Pharmaceutical Companies of Johnson & Johnson.

Pro­tect­ing the glob­al phar­ma­ceu­ti­cal in­no­va­tion ecosys­tem – what’s at stake?

We are living in a new era of healthcare that is rapidly advancing progress impacting patient outcomes and experiences. We’ve seen a remarkable pace of transformational innovation, applied research, and advanced clinical development over the last decade.

Despite this tremendous progress, there is much more work to be done, and patients are counting on us – now more than ever – to continue that momentum. At the heart of our industry is a focus on developing and delivering medicines for some of the world’s most challenging diseases, including those that have few or no effective treatments today.

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