Trends in Out-of-Pocket Costs for Naloxone by Drug Brand and Payer in the US, 2010-2018

Peet, Evan D.; Powell, David; Pacula, Rosalie Liccardo

doi:10.1001/jamahealthforum.2022.2663

Cited by 17 publications

(10 citation statements)

References 24 publications

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“…To compound this issue, to our knowledge, no studies have evaluated price sensitivity of naloxone for patients. While 1 study identified that naloxone was price inelastic, the study did not specifically examine price elasticity for uninsured individuals and contradicted more recent evidence suggesting that price sensitivity is a barrier to naloxone use, especially for those who are uninsured . In the context of over-the-counter naloxone, lack of appropriate pricing strategies suited to over-the-counter sales may prohibit naloxone use.…”

Section: Discussionmentioning

confidence: 88%

Naloxone Accessibility Under the State Standing Order Across Mississippi

et al. 2023

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ImportanceNaloxone is a life-saving medication for individuals experiencing an opioid overdose. Naloxone standing orders aim to make naloxone more available by allowing patients improved access to this medication at community pharmacies; however, lawful availability does not mean that this life-saving intervention is accessible to patients.ObjectiveTo characterize naloxone availability and out-of-pocket cost under the state standing order in Mississippi.Design, Setting, and ParticipantsThis telephone-based, mystery-shopper census survey study included Mississippi community pharmacies open to the general public in Mississippi at the time of data collection. Community pharmacies were identified using the Hayes Directories April 2022 complete Mississippi pharmacy database. Data were collected from February to August 2022.ExposuresMississippi House bill 996, the Naloxone Standing Order Act, signed into law in 2017, allowing pharmacists to dispense naloxone under a physician state standing order at a patient’s request.Main Outcomes and MeasuresThe main outcomes were naloxone availability under Mississippi’s state standing order and the out-of-pocket cost of available formulations.ResultsThere were 591 open-door community pharmacies surveyed for this study, with a 100% response rate. The most common pharmacy type was independent (328 [55.50%]), followed by chain (147 [24.87%]) and grocery store (116 [19.63%]). When asked, “Do you have naloxone that I can pick up today?” 216 Mississippi pharmacies (36.55%) had naloxone available for purchase under the state standing order. Of the 591 pharmacies, 242 (40.95%) were unwilling to dispense naloxone under the state standing order. Among the 216 pharmacies with naloxone available, the median out-of-pocket cost for naloxone nasal spray (n = 202) across Mississippi was $100.00 (range, $38.11-$229.39; mean [SD], $105.58 [$35.42]) and the median out-of-pocket cost of naloxone injection (n = 14) was $37.70 (range, $17.00-$208.96; mean [SD], $66.62 [$69.27]).Conclusions and RelevanceIn this survey study of open-door Mississippi community pharmacies, availability of naloxone was limited despite standing order implementation. This finding has important implications for the effectiveness of the legislation in preventing opioid overdose deaths in this region. Further studies are needed to understand pharmacists’ unwillingness to dispense naloxone and the implications of lack of availability and unwillingness for further naloxone access interventions.

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Section: Discussionmentioning

confidence: 88%

Naloxone Accessibility Under the State Standing Order Across Mississippi

et al. 2023

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“…Third, only payer policies for Medicaid were examined in this study. Private health plans typically have large variation in naloxone coverage and uninsured individuals are increasingly burdened with out-of-pocket costs ( Peet et al, 2022 ). However, given that all four states are Medicaid-expansion states, a large portion of individuals at risk for opioid overdose are likely covered by Medicaid.…”

Section: Discussionmentioning

confidence: 99%

“…Reimbursement and insurance coverage for naloxone have been increasing among public and private payors ( Sohn et al, 2020 ). However, the price of naloxone without insurance remains high and insurance may only partially cover the expense ( Peet et al, 2022 ). Even though Medicaid beneficiaries face lower costs, these costs may still be a barrier for low-income individuals.…”

Section: Introductionmentioning

confidence: 99%

The policy landscape for naloxone distribution in four states highly impacted by fatal opioid overdoses

Bohler

Freeman

Villani

et al. 2023

Drug and Alcohol Dependence Reports

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“…A body of implementation research has also raised questions about the extent to which NALs are capable of increasing naloxone distribution given lack of knowledge among pharmacists about their state NALs (Thakur et al, 2020) and failure to stock naloxone in pharmacies (Abbas et al, 2021;Eldridge et al, 2020;Graves et al, 2019;Meyerson et al, 2018;Spivey et al, 2020). Finally, one criticism of pharmacy-focused laws is that they may not be effective at helping vulnerable or disadvantaged populations who face stigma from prescribers and pharmacists Smart & Grant, 2021) and for whom the often-substantial price of naloxone (Peet et al, 2022) may represent a serious access barrier. However, no study has evaluated differential effects of NALs on naloxone receipt across population subgroups.…”

Section: Introductionmentioning

confidence: 99%