Medicaid prescription limits and their implications for naloxone accessibility.
Analgesics, Opioid
/ poisoning
COVID-19
Cross-Sectional Studies
Drug Overdose
/ drug therapy
Drug Prescriptions
Humans
Medicaid
/ legislation & jurisprudence
Naloxone
/ therapeutic use
Narcotic Antagonists
/ therapeutic use
Pandemics
Practice Patterns, Physicians'
Surveys and Questionnaires
United States
/ epidemiology
Access
Medicaid
Naloxone
Opioid overdose
Pharmaceutical policy
Journal
Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587
Informations de publication
Date de publication:
01 01 2021
01 01 2021
Historique:
received:
19
08
2020
revised:
07
10
2020
accepted:
08
10
2020
pubmed:
15
12
2020
medline:
31
12
2020
entrez:
14
12
2020
Statut:
ppublish
Résumé
Expanding access to and utilization of naloxone is a vitally important harm reduction strategy for preventing opioid overdose deaths, particularly in vulnerable populations like Medicaid beneficiaries. The objective of this study was to characterize the landscape of monthly prescription fill limit policies in Medicaid programs and their potential implications for expanding naloxone use for opioid overdose harm reduction. A cross-sectional, multi-modal online and telephonic data collection strategy was used to identify and describe the presence and characteristics of monthly prescription fill limit policies across state Medicaid programs. Contextual characteristics were described regarding each state's Medicaid enrollment, opioid prescribing rates, and overdose death rates. Data collection and analysis occurred between February and May 2020. Medicaid-covered naloxone fills are currently subject to monthly prescription fill limit policies in 10 state Medicaid programs, which cover 20 % of the Medicaid population nationwide. Seven of these programs are located in states ranking in the top 10 highest per-capita opioid prescribing rates in the country. However, 8 of these programs are located in states with opioid overdose death rates below the national average. Medicaid beneficiaries at high risk of opioid overdose living in states with monthly prescription fill limits may experience significant barriers to obtaining naloxone. Exempting naloxone from Medicaid prescription limit restrictions may help spur broader adoption of naloxone for opioid overdose mortality prevention, especially in states with high opioid prescribing rates. Achieving unfettered naloxone coverage in Medicaid is critical as opioid overdoses and Medicaid enrollment increase amid the COVID-19 pandemic.
Sections du résumé
BACKGROUND
Expanding access to and utilization of naloxone is a vitally important harm reduction strategy for preventing opioid overdose deaths, particularly in vulnerable populations like Medicaid beneficiaries. The objective of this study was to characterize the landscape of monthly prescription fill limit policies in Medicaid programs and their potential implications for expanding naloxone use for opioid overdose harm reduction.
METHODS
A cross-sectional, multi-modal online and telephonic data collection strategy was used to identify and describe the presence and characteristics of monthly prescription fill limit policies across state Medicaid programs. Contextual characteristics were described regarding each state's Medicaid enrollment, opioid prescribing rates, and overdose death rates. Data collection and analysis occurred between February and May 2020.
RESULTS
Medicaid-covered naloxone fills are currently subject to monthly prescription fill limit policies in 10 state Medicaid programs, which cover 20 % of the Medicaid population nationwide. Seven of these programs are located in states ranking in the top 10 highest per-capita opioid prescribing rates in the country. However, 8 of these programs are located in states with opioid overdose death rates below the national average.
CONCLUSIONS
Medicaid beneficiaries at high risk of opioid overdose living in states with monthly prescription fill limits may experience significant barriers to obtaining naloxone. Exempting naloxone from Medicaid prescription limit restrictions may help spur broader adoption of naloxone for opioid overdose mortality prevention, especially in states with high opioid prescribing rates. Achieving unfettered naloxone coverage in Medicaid is critical as opioid overdoses and Medicaid enrollment increase amid the COVID-19 pandemic.
Identifiants
pubmed: 33309522
pii: S0376-8716(20)30520-2
doi: 10.1016/j.drugalcdep.2020.108355
pmc: PMC7568500
mid: NIHMS1642201
pii:
doi:
Substances chimiques
Analgesics, Opioid
0
Narcotic Antagonists
0
Naloxone
36B82AMQ7N
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
108355Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR002367
Pays : United States
Organisme : NIDA NIH HHS
ID : R34 DA046598
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020. Published by Elsevier B.V.