GiveBetter x SF

Remedy Alliance / For The People

Low-cost naloxone access through community harm-reduction programs

Research time: ~15 min on GPT-5.6 Sol Medium
  • Research — organization and evidence review.
  • Modeling — cost-effectiveness analysis.
  • Historical estimate for research done before time tracking.

Published: September 8, 2026.

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Summary

What do they do? Remedy supplies low-cost or free naloxone to community organizations and provides technical assistance. It is a California NDP partner and also serves a national network. More

Why this approach interests us

  • Low-cost supply can reach people likely to witness an overdose, where timely naloxone can prevent a fatal outcome.

Our main reservations

  • The model depends on uncertain additional supply, actual use and person-linked survival. Reported reversals are not lives saved.

What do you get for your dollar?

This represents an ordinary gift to Remedy’s naloxone-access core across its national network—not a California-only gift. The central gross associated-resource estimate is $116,785, above our $100,000 target. SF and Bay benefit shares are unknown. That is $7,616 per overall QALY. Inspect all formulas, inputs and sources.

overall estimate
$76,164 / 10 QALYs — National representative-core estimate with explicit donor-additionality judgments.
associated resources
$116,785 / 10 QALYs — Gross downstream-resource stress, not net societal cost.
sf / bay share
Unknown — A California warehouse or public contract does not identify beneficiary residence.
evidence
Clinical and observational — No randomized Remedy donor-to-mortality estimate.

1. What do they do?

Remedy supplies low-cost or free naloxone to community organizations and provides technical assistance. It is a California NDP partner and also serves a national network.

Support community supply

Procurement and fulfillment help organizations obtain medicine for people who use drugs and their networks.

Complete the last mile

Health depends on distribution, availability during an overdose and additional rescue—not on shipment counts alone.

Scope of this review. We assign 80% of an ordinary gift to the naloxone core by judgment. Core costs already include administration; this is not another overhead haircut. Other activity receives no numerical benefit credit, but is not known to have zero impact.

2. Monitoring and information sharing

Massachusetts communities, Walley et al. 2013

Interrupted time series. Greater overdose-education/naloxone implementation was associated with lower overdose mortality.

Our assessment. Historical observational comparisons support plausibility but cannot be applied as Remedy’s donor-specific mortality percentage.

Pittsburgh harm-reduction participants, 2005–2023

Administrative cohort, published 2025. Reported responses demonstrate actual peer naloxone use; reported survival was 98%.

Our assessment. No untreated comparator. Survival after response is not survival caused by supply. Repeat recipients, events and formulation differences matter; Remedy affiliations are disclosed.

Remedy’s California and national supply network

Primary organizational and payer documentation. DHCS identifies Remedy as its injectable-naloxone distribution partner.

Our assessment. This verifies delivery and a public funding baseline, not a new charitable gap or the location of marginal beneficiaries.

3. Qualitative assessment

Low-cost supply can reach people likely to witness an overdose, where timely naloxone can prevent a fatal outcome.

Key reservations

  • Shipment, dose and reversal counts are not interchangeable with incremental lives saved.
  • Multiple bundles at a scene and repeated rescues of the same person must not duplicate event or survival credit.
  • The current marginal product mix, funding gap and geographic allocation are unknown.
  • The central gross-resource result exceeds $100,000 per 10 QALYs.

Benefits not included in our estimate

  • Drug-checking, community-support and other noncore health effects.
  • Unmeasured nonfatal injury or treatment-entry benefits.
  • Unverified SF/Bay or international spillovers.
  • Healthcare savings and financial transfers treated as health benefits.

4. What do you get for your dollar?

A $10,000 gift yields an estimated 1.31295 overall QALYs.

We use a standardized four-injectable-dose-equivalent bundle solely for procurement accounting—not a clinical dosing recommendation or a fixed product mix. Every cost and use assumption refers to that unit. Events are deduplicated across all bundles; person-time is deduplicated across repeated rescues.

A better life is our comparison unit of 10 additional quality-adjusted life years (QALYs), potentially spread across people. These are uncertain estimates, not measured returns or verified donation offers.

How we calculate the estimate

Central model: 533.333 bundles × .40 additionality × (.05 unique-event equivalents × .05 person-linked survival equivalents × 2.54364 Q − .00002 shared harm) / 1.03
1.31295 QALYs; $10,000 × 10 / 1.31295 = $76,164

Model inputs and assumptions
Marginal core allocation
80% (range: 50–95%). General-gift core share; all gift dollars remain in the numerator. Judgment.
Cash per accounting bundle
$15 (range: $10–$30). Approximately $7 commodity, $3 fulfillment and $5 support/administration. Historical injectable pricing is not a current quote or a nasal-product price. Judgment.
Other associated resources
$10 per bundle (range: $5–$20). Downstream time and supplies outside Remedy cash; charged on all funded bundles, including unused ones. Judgment.
Nonduplicated response-equivalents
.05 per bundle in 12 months (range: .01–.10). Includes last-mile failure, nonuse and expiry. Several funded bundles at one scene share one event credit. Judgment.
Person-linked survival-equivalents
.05 per qualifying event (range: .02–.10). Marginal first-rescue-equivalent survival after alternative rescue and overlapping tails from repeated rescues of the same person. Not raw rescue survival. Judgment.
Funding/output additionality
40% (range: 0–70%). Beyond public funding, other donors, existing stock and cross-subsidized supply; separate from alternative rescue at an event. Judgment.
Finite survival difference
5 years; .90 annual survival; .70 utility (range: 2–10 years; separate 1-year stress). 3% discount and a rescue midpoint one year after the gift. Annual mortality does not itself remove duplicate person-time. Judgment.

How much could the estimate change?

  • central: $76,164 per 10 US-wide QALYs. 1.3130 net QALYs from the same gift; $116,785 with gross associated resources. SF and Bay Area shares remain unknown.
  • favorable: $3,069 per 10 US-wide QALYs. 32.580 net QALYs from the same gift; $4,527 with gross associated resources. SF and Bay Area shares remain unknown.
  • pessimisticPositive: $37,356,167 per 10 US-wide QALYs. 0.0026769 net QALYs from the same gift; $49,808,223 with gross associated resources. SF and Bay Area shares remain unknown.
  • fundingReplacementNull: No positive-health ratio per 10 US-wide QALYs. 0.0000 net QALYs from the same gift; No positive-health ratio with gross associated resources. SF and Bay Area shares remain unknown.
  • clinicalNull: No positive-health ratio per 10 US-wide QALYs. 0.0000 net QALYs from the same gift; No positive-health ratio with gross associated resources. SF and Bay Area shares remain unknown.
  • clinicalNullWithSharedHarm: No positive-health ratio per 10 US-wide QALYs. -0.0041424 net QALYs from the same gift; No positive-health ratio with gross associated resources. SF and Bay Area shares remain unknown.
  • fundingNullWithIndependentHarm: No positive-health ratio per 10 US-wide QALYs. -0.10000 net QALYs from the same gift; No positive-health ratio with gross associated resources. SF and Bay Area shares remain unknown.
  • oneYearSurvival: $298,800 per 10 US-wide QALYs. 0.33467 net QALYs from the same gift; $458,160 with gross associated resources. SF and Bay Area shares remain unknown.
  • independentNetHarm: No positive-health ratio per 10 US-wide QALYs. -3.6870 net QALYs from the same gift; No positive-health ratio with gross associated resources. SF and Bay Area shares remain unknown.
  • caDensePublicSubstitutionStress: $304,657 per 10 US-wide QALYs. 0.32824 net QALYs from the same gift; $467,140 with gross associated resources. SF and Bay Area shares remain unknown.

Uncertainty. These are joint analyst scenarios, not confidence intervals. Each person’s survival tail is credited once or partitioned into genuinely incremental intervals. The .05 survival coefficient already includes a judgment about repeat-rescue overlap. The model does not empirically identify unique lives saved.

5. Funding and previous grants

Clarify the marginal supply mix and missing downstream access beyond public funding. This is a conditional model, not a verified donor offer or robust full-resource result.

California NDP already provides free naloxone through Remedy and has supplied all 58 counties. Existing public contracts, tiered sales, commodity donations and a working-capital loan are baseline or substitutes—not a fresh gift’s impact. The model’s 40% additionality is a national judgment, not a verified unfunded queue. Costs plus external resources are gross associated commitments, not net societal incremental costs at the replacement null. Do not give full additive credit for one episode to Remedy, NDP and downstream organizations.

This review does not establish a verified marginal funding offer or a complete history of grants.

Donate

Opens the organization’s giving page. A general donation may not fund the specific activity modeled here; confirm allocation with the recipient.

6. Sources

  1. Program and organization. Remedy Alliance. Primary organizational description. Published: Current page; retrieved: September 8, 2026.
  2. General giving. Remedy Alliance. Primary donation route. Published: Current page; retrieved: September 8, 2026.
  3. Products available through NDP. California DHCS. Primary public payer/program. Published: Current page; retrieved: September 8, 2026.
  4. Naloxone Distribution Project. California DHCS. Primary public baseline. Published: Current page; retrieved: September 8, 2026.
  5. Overdose education and naloxone distribution in Massachusetts. Walley et al.. Primary observational study abstract. Published: 2013; retrieved: September 8, 2026.
  6. Seventeen years of Pittsburgh naloxone distribution and administration. Dasgupta et al.. Primary administrative cohort. Published: October 24, 2025; retrieved: September 8, 2026.
  7. First ten months of naloxone distribution. Remedy Alliance. Historical primary activity/price context. Published: 2023; retrieved: September 8, 2026.
  8. Working-capital loan to Remedy Alliance. Soros Economic Development Fund. Primary lender record. Published: December 2023; retrieved: September 8, 2026.

Annual expenses: years and sources

Average annual expenses (three consecutive fiscal years): Not available. Organization size is separate from the modeled cost-effectiveness of a donation.

Remedy Alliance / For The People

Three years of organization-level expenses have not yet been verified for this report. No other organization or fiscal sponsor budget has been substituted.

How much might this help San Francisco?

Our rough local estimate is $15.2M per 10 SF-resident QALYs, or $3.8M per 10 Bay Area QALYs. We assign 0.5% of marginal national health to SF and 2% to the Bay, including SF. These are broad analyst judgments—not measured shipment or beneficiary shares. The full national gift remains the cost.

California’s public program confirms a Remedy supply pathway. Local overdose burden makes some benefit plausible, but substantial existing provision and unknown marginal destinations make the share highly uncertain. There is no second local funding discount. Shared clinical benefits and harms are assumed to have the same regional proportions.

Local-share sensitivities

These hold national clinical assumptions fixed. Null or harmful national effects do not become positive through geography. Independent harms need their own location assumptions; they are not automatically distributed by benefit shares.