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Thought leadership on the clinical impact on workers' compensation and auto no-fault.

New medication now available – Opvee® (nalmefene) nasal spray for opioid-related overdose

November 17, 2023 · Clinical Team

Opvee® (nalmefene) 2.7 mg nasal spray, the first nalmefene nasal spray approved by the U.S. Food and Drug Administration (FDA), and marketed by Indivior Inc., is now available.

Approved back in May 2023 by the FDA, Opvee is labeled for the emergency treatment of known or suspected overdose induced by natural or synthetic opioids in patients aged 12 years and older. Opvee is indicated for immediate administration in suspected overdose as manifested by respiratory and/or central nervous system depression as an emergency therapy in settings where opioid analgesics may be present. The medication is not a substitute for emergency medical care by trained healthcare professionals.

Nalmefene is an opioid antagonist, similar to naloxone, designed to rapidly reverse the potentially life-threatening adverse effects of opioid analgesic overdose. Indivior markets Opvee as “the first and only nasal rescue medicine specifically for synthetic opioids” such as fentanyl. 

Impact on workers’ compensation and auto no-fault

Because Opvee nasal spray is new, treatment guidelines do not yet address its use. Opvee nasal spray is expected to be prescribed in patients taking opioid analgesics for chronic pain and/or at risk for opioid-related overdose.

Prior to a full review by the Optum Pharmacy and Therapeutics (P&T) Committee in the fourth quarter, Opvee nasal spray will be non-formulary on all standard formularies.

For more information on Opvee, click here.

Impact on Optum Settlement Solutions clients

The Centers for Medicare & Medicaid Services (CMS) should allocate Opvee nasal spray in the same manner as naloxone products at one unit (syringe or nasal spray device) per year. In reference to Workers’ Compensation Medicare set-asides (WCMSAs), the exposure for these opioid antagonists is not significant. The WCMSA cost allocated per year is noted below:

Medication name Brand/Generic National Drug Code Quantity AWP*
Opvee 2.7 mg/0.1 ml (nalmefene) nasal spray  Brand 12496-0003-02 1 $58.80
Narcan 4 mg /0.1 ml (naloxone) nasal spray  Brand 69547-0353-02 1 $75.00
Naloxone 4 mg/0.1 ml nasal spray  Generic 45802-0811-84 1 $64.80

*RED BOOK® Average Wholesale Price (AWP) is subject to change

If you have any questions, please contact  your account manager or our Clinical Services team at 1-877-275-7674 ext. 8612.



  1. Press Release. Indivior Announces U.S. Food and Drug Administration Approval of OPVEE® (nalmefene) Nasal Spray, An Opioid Overdose Rescue Medicine for Natural and Synthetic Opioids Like Fentanyl. May 22, 2023. Available at: Indivior | Indivior PLC – OPVEE FDA Approval (
  2. Merative Micromedex® DRUGDEX® (electronic version). Merative, Ann Arbor, Michigan, USA. c2023 - [cited 2023 November 13].
  3. WCMSA Reference Guide –WCMSA Reference Guide Version 3.8.
  4. ODG by MCG Treatment Guidelines [database online]. An MCG Health Company. Accessed on November 13, 2023.

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