Physician-approved protocols increase naloxone dispensing rates

Area of Science:

• Public Health
• Pharmacology
• Health Policy

Background:

• Naloxone is a critical medication for reversing opioid overdoses.
• Barriers to naloxone access can limit its availability.
• Physician-approved protocols may expand pharmacist-led naloxone distribution.

Purpose of the Study:

• To evaluate the impact of a law enabling pharmacists to dispense naloxone under a physician-approved protocol.
• To assess changes in naloxone dispensing rates across an all-payer population in the U.S.

Main Methods:

• Retrospective analysis of prescription claims from a national grocery chain (31 states).
• Study period: July 2014 to January 2017.
• Statistical analysis using stepwise autoregression to evaluate dispensing rate changes based on protocol implementation.

Main Results:

• States with physician-approved protocols saw a 423% higher rate of naloxone prescriptions compared to states without.
• Overall dispensing rates were 6 times higher with the protocol.
• Dispensing rates were highest for Medicare (9.0x), Private (4.6x), Medicaid (3.2x), and Cash (3.1x) payers.

Conclusions:

• Implementation of physician-approved protocols strongly correlates with increased naloxone dispensing.
• This policy significantly enhances access to naloxone, especially in low-employment areas.
• Expanded pharmacist authority is an effective strategy for improving public health outcomes in opioid crisis response.