The association between naloxone claims and proportion of independent vs. chain pharmacies: A longitudinal analysis of naloxone claims in the US.

chain pharmacy dispensing independent pharmacy naloxone

Journal

Journal of the American Pharmacists Association : JAPhA
ISSN: 1544-3450
Titre abrégé: J Am Pharm Assoc (2003)
Pays: United States
ID NLM: 101176252

Informations de publication

Date de publication:
09 Apr 2024
Historique:
received: 21 12 2023
revised: 27 03 2024
accepted: 07 04 2024
medline: 12 4 2024
pubmed: 12 4 2024
entrez: 11 4 2024
Statut: aheadofprint

Résumé

Expanding access to naloxone through pharmacies is an important policy goal. Our objective was to characterize national county-level naloxone dispensing of chain versus independent pharmacies. The primary exposure in our longitudinal analysis was the proportion of chain pharmacies in a county, identified through the US Department of Homeland Security 2010 Infrastructure Foundation-Level Data. We defined counties as having "higher proportion" of chain pharmacies if at least 50% of pharmacies were large national chains. The primary outcome was quarter-year (2016Q1-2019Q2) rate of pharmacy naloxone claims per 100,000 persons from Symphony Health at the county-level. We compared the naloxone dispensing rate between county types using two-sample t-tests. We estimated the association between county-level chain pharmacy proportion and rate of naloxone claims using a linear model with year-quarter fixed effects. Nearly one third of counties (n=946) were higher proportion. Higher proportion counties had a significantly higher rate of naloxone claims across the study period, in 4 of 6 urban-rural classifications, and in counties with and without naloxone access laws. The linear model confirmed that higher proportion counties had a significantly higher rate of naloxone claims, adjusting for urban/rural designation, income, population characteristics, opioid mortality rate, co-prescribing laws and naloxone access laws. In this national study, we found an association between naloxone dispensing rates and the county-level proportion of chain (versus independent) pharmacies. Incentivizing naloxone dispensing through educational, regulatory, or legal efforts may improve naloxone availability and dispensing rates - particularly in counties with proportionately high numbers of independent pharmacies.

Sections du résumé

BACKGROUND BACKGROUND
Expanding access to naloxone through pharmacies is an important policy goal. Our objective was to characterize national county-level naloxone dispensing of chain versus independent pharmacies.
METHODS METHODS
The primary exposure in our longitudinal analysis was the proportion of chain pharmacies in a county, identified through the US Department of Homeland Security 2010 Infrastructure Foundation-Level Data. We defined counties as having "higher proportion" of chain pharmacies if at least 50% of pharmacies were large national chains. The primary outcome was quarter-year (2016Q1-2019Q2) rate of pharmacy naloxone claims per 100,000 persons from Symphony Health at the county-level. We compared the naloxone dispensing rate between county types using two-sample t-tests. We estimated the association between county-level chain pharmacy proportion and rate of naloxone claims using a linear model with year-quarter fixed effects.
RESULTS RESULTS
Nearly one third of counties (n=946) were higher proportion. Higher proportion counties had a significantly higher rate of naloxone claims across the study period, in 4 of 6 urban-rural classifications, and in counties with and without naloxone access laws. The linear model confirmed that higher proportion counties had a significantly higher rate of naloxone claims, adjusting for urban/rural designation, income, population characteristics, opioid mortality rate, co-prescribing laws and naloxone access laws.
CONCLUSION CONCLUSIONS
In this national study, we found an association between naloxone dispensing rates and the county-level proportion of chain (versus independent) pharmacies. Incentivizing naloxone dispensing through educational, regulatory, or legal efforts may improve naloxone availability and dispensing rates - particularly in counties with proportionately high numbers of independent pharmacies.

Identifiants

pubmed: 38604474
pii: S1544-3191(24)00113-4
doi: 10.1016/j.japh.2024.102093
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102093

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Christina E Freibott (CE)

Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA. Electronic address: freibott@bu.edu.

Ali Jalali (A)

Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA.

Sean M Murphy (SM)

Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA.

Alexander Y Walley (AY)

Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA.

Benjamin P Linas (BP)

Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA.

Philip J Jeng (PJ)

Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA.

Jeffrey Bratberg (J)

The University of Rhode Island, College of Pharmacy, Kingston, RI, USA.

Brandon D L Marshall (BDL)

Brown University School of Public Health, Department of Epidemiology, Providence, RI, USA; COBRE on Opioids and Overdose, Rhode Island Hospital, Providence, RI, USA.

Xiao Zang (X)

University of Minnesota, School of Public Health, Division of Health Policy and Management, Minneapolis, MN, USA.

Traci C Green (TC)

Brown University School of Public Health, Department of Epidemiology, Providence, RI, USA; COBRE on Opioids and Overdose, Rhode Island Hospital, Providence, RI, USA; Brandeis University Heller School for Social Policy and Management; Rhode Island Hospital, RI, USA.

Jake R Morgan (JR)

Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA.

Classifications MeSH