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Insurance coverage and consistent pricing is needed for over-the-counter naloxone
Blake Fagan1, Delesha Carpenter2, Grace Marley3
1Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill; Physician, Mountain Area Health Education Center, Asheville, North Carolina.
Journal of Opioid Management
|January 8, 2025
Summary
Despite the 2023 approval of over-the-counter naloxone nasal spray, insurance coverage varies, hindering access. Universal insurance coverage and opioid settlement funds are proposed to ensure equitable access to this overdose reversal medication.
Area of Science:
- Pharmacology and Public Health
- Opioid Overdose Prevention
Background:
- The 2023 FDA approval of the first over-the-counter naloxone nasal spray aimed to improve access and reduce costs.
- Naloxone is a critical medication for reversing opioid overdoses.
Purpose of the Study:
- To assess the real-world insurance coverage of naloxone nasal spray following its over-the-counter availability.
- To identify barriers to equitable access to naloxone.
Main Methods:
- Analysis of insurance coverage during attempted purchases of naloxone nasal spray at local pharmacies.
- Commentary on the implications of variable insurance coverage on medication access.
Main Results:
- Observed significant variation in insurance coverage for naloxone nasal spray across different pharmacies.
- Inconsistent coverage poses a barrier to accessing this life-saving overdose reversal medication.
Conclusions:
- Federal policy mandating universal insurance coverage for at least one naloxone formulation is recommended.
- Utilizing national opioid settlement funds can ensure equitable access to naloxone nasal spray.
- Addressing insurance disparities is crucial to prevent overdose deaths.
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