Retrospective study investigating naloxone prescribing and cost in US Medicaid and Medicare patients

BackgroundOpioid overdoses in the USA have increased to unprecedented levels. Administration of the opioid antagonist naloxone can prevent overdoses.ObjectiveThis study was conducted to reveal the pharmacoepidemiologic patterns in naloxone prescribing to Medicaid patients from 2018 to 2021 as well a...

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Bibliographic Details
Published in:	BMJ open Vol. 14; no. 5; p. e078592
Main Authors:	Manko, Christopher D, Ahmed, Mohamed S, Harrison, Lavinia R, Kodavatiganti, Srivastava A, Lugo, Noelia, Konadu, Jason Osei, Khan, Farrin, Massari, Carrie A, Sealey, Tenisha K, Addison, Maame Efua, Mbah, Celine N, McCall, Kenneth L, Fraiman, Joseph B, Piper, Brian J
Format:	Journal Article
Language:	English
Published:	England British Medical Journal Publishing Group 01-05-2024 BMJ Publishing Group LTD BMJ Publishing Group
Subjects:	CLINICAL PHARMACOLOGY Drug overdose Drug Prescriptions - economics Drug Prescriptions - statistics & numerical data Drug stores EPIDEMIOLOGY Humans Male Medicaid Medicaid - economics Medicaid - statistics & numerical data Medicare Medicare - economics Naloxone - economics Naloxone - therapeutic use Narcotic Antagonists - economics Narcotic Antagonists - therapeutic use Narcotics Patients Pharmacology and therapeutics Pharmacy Practice Patterns, Physicians' - statistics & numerical data Prescription drugs PUBLIC HEALTH Retrospective Studies Trends United States United States South Dakota Rhode Island New Mexico United States > US PUBLIC HEALTH CLINICAL PHARMACOLOGY EPIDEMIOLOGY
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Summary:	BackgroundOpioid overdoses in the USA have increased to unprecedented levels. Administration of the opioid antagonist naloxone can prevent overdoses.ObjectiveThis study was conducted to reveal the pharmacoepidemiologic patterns in naloxone prescribing to Medicaid patients from 2018 to 2021 as well as Medicare in 2019.DesignObservational pharmacoepidemiologic studySettingUS Medicare and Medicaid naloxone claimsInterventionThe Medicaid State Drug Utilisation Data File was utilised to extract information on the number of prescriptions and the amount prescribed of naloxone at a national and state level. The Medicare Provider Utilisation and Payment was also utilised to analyse prescription data from 2019.Outcome measuresStates with naloxone prescription rates that were outliers of quartile analysis were noted.ResultsThe number of generic naloxone prescriptions per 100 000 Medicaid enrollees decreased by 5.3%, whereas brand naloxone prescriptions increased by 245.1% from 2018 to 2021. There was a 33.1-fold difference in prescriptions between the highest (New Mexico=1809.5) and lowest (South Dakota=54.6) states in 2019. Medicare saw a 30.4-fold difference in prescriptions between the highest (New Mexico) and lowest states (also South Dakota) after correcting per 100 000 enrollees.ConclusionsThis pronounced increase in the number of naloxone prescriptions to Medicaid patients from 2018 to 2021 indicates a national response to this widespread public health emergency. Further research into the origins of the pronounced state-level disparities is warranted.
Bibliography:	Original research ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2023-078592