Laws Mandating Coprescription of Naloxone and Their Impact on Naloxone Prescription in Five US States, 2014-2018

• Published in: American journal of public health (1971) 2020-06, Vol.110 (6), p.881-887
• Main Authors: Green, Traci C, Davis, Corey, Xuan, Ziming, Walley, Alexander Y, Bratberg, Jeffrey
• Format: Article
• Language: English
• Subjects: AJPH Open-Themed Research; Benzodiazepines; Dispensing; Drug and Narcotic Control - legislation & jurisprudence; Drug dosages; Drug overdose; Drug Overdose - drug therapy; Drug Overdose - prevention & control; Drug Prescriptions - statistics & numerical data; Drug stores; Drugs; Health Law; Health Services Accessibility - legislation & jurisprudence; Humans; Injury/Emergency Care/Violence; Linear analysis; Medicaid; Medicare; Naloxone; Naloxone - supply & distribution; Naloxone - therapeutic use; Narcotics; Overdose; Patients; Pharmacists; Pharmacy; Prescriptions; Public health; States; United States
• ISSN: 0090-0036; 1541-0048; 1541-0048
• DOI: 10.2105/AJPH.2020.305620

To examine early impacts of laws that require naloxone to be prescribed to patients at increased overdose risk. Using data from 2014 to 2018 from a large pharmacy chain, CVS Pharmacy, we examined the effects of naloxone-prescribing mandates 90 days before and after they took effect in Arizona, Florida, Rhode Island, Vermont, and Virginia. We compared the number of naloxone doses initiated directly by prescribers and by pharmacy standing order, prescriber specialty, pharmacies dispensing, and payor type by applying linear models and the χ test. Naloxone-prescribing mandates increased pharmacy naloxone provision 255% from 90 days before to after implementation. This approach appeared to engage more prescribers (1028 before to 4285 after), complement ongoing naloxone provision under pharmacy standing orders, expand geographic reach (from 40% to 80% of pharmacies dispensing), and broaden the naloxone payor mix in 4 (