Access to naloxone for patients covered by Medicare and commercial insurance has been reduced during the COVID-19 pandemic, but not for the uninsured or those on Medicaid. These findings were published in JAMA Health Forum.
Data from the pharmacy claims database Symphony Health, which included 92% of national retail pharmacy claims, 71% of mail-order claims, and 65% of specialty pharmacy activities in the US, were analyzed. Trends in opioid and naloxone prescriptions between May 2019 and December 2020 were assessed. Prepandemic periods were defined as May 13, 2019, to March 13, 2020.
At the start of the pandemic, naloxone prescriptions decreased by 26.32% corresponding with an average of 361.09 (95% CI, -499.56 to -222.62; P £.05) fewer individuals filling their prescription. Stratified by insurance type, the change in naloxone prescriptions was -34.15% for Medicare, -31.20% for commercial insurance, -1.72% for Medicaid, and -4.24% for uninsured claims.
During the same time period, all medication prescriptions decreased by 14.76% (872.95; 95% CI, -1051.36 to -694.54 fewer individuals per tens of thousands; P £.05) and opioid prescriptions by 8.71% (230.97; 95% CI, -343.93 to -118.01 fewer individuals per thousands; P £.05).
A recovery in naloxone prescriptions has not been observed (change in weekly growth rate, 0.36%; 95% CI, -0.17% to 0.88%) whereas all prescriptions (-0.57%; 95% CI, -0.72% to -0.42%; P £.05) and opioid prescriptions (-0.23%; 95% CI, -0.43% to -0.03%; P £.05) have been declining since the pandemic began.
This study was unable to account for distribution of naloxone kits from other services such as syringe exchange programs. It may be possible such programs compensated for a decrease in naloxone purchases during the COVID-19 pandemic.
These data indicated patients covered by Medicare and commercial insurance, but not the uninsured or those covered by Medicaid, had decreased access to naloxone during the COVID-19 pandemic. No evidence suggests there has been a rebound of naloxone access.
Disclosure: Several study authors received declared affiliations with Google.org. Please see the original reference for a full list of disclosures.
O’Donoghue AL, Biswas N, Dechen T, et al. Trends in filled naloxone prescriptions before and during the COVID-19 pandemic in the United States. JAMA Health Forum. 2021;2(5):e210393. doi:10.1001/jamahealthforum.2021.0393