Association between state Medicaid expansion status and naloxone prescription dispensing

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective: To test whether Medicaid expansion is associated with (a) a greater number of naloxone prescriptions dispensed and (b) a higher proportion of naloxone prescriptions paid by Medicaid. Data Sources/Study Setting: We used the IQVIA National Prescription Audit to obtain data on per state per quarter naloxone prescription dispensing for the period 2011-16. Study Design: In this quasi-experimental design study, the impact of Medicaid expansion on naloxone prescription dispensing was examined using difference-in-difference estimation models. State-level covariates including pharmacy-based naloxone laws (standing/protocol orders and direct authority to dispense naloxone), third-party prescribing laws, opioid analgesic prescribing rates, opioid-involved overdose death rates, and population size were controlled for in the analysis. Principal Findings: Medicaid expansion was associated with 38 additional naloxone prescriptions dispensed per state per quarter compared to nonexpansion controls, on average (P =.030). Also, Medicaid expansion resulted in an average increase of 9.86 percent in the share of naloxone prescriptions paid by Medicaid per state per quarter (P <.001). Conclusions: Our study found that Medicaid expansion increased naloxone availability. This finding suggests that it will be important to consider naloxone access when making federal- and state-level decisions affecting Medicaid coverage.

Original languageEnglish
Pages (from-to)239-248
Number of pages10
JournalHealth Services Research
Issue number2
StatePublished - Apr 1 2020

Bibliographical note

Publisher Copyright:
© Health Research and Educational Trust


  • Medicaid
  • Patient Protection and Affordable Care Act
  • drug overdose
  • naloxone
  • opioid epidemic

ASJC Scopus subject areas

  • Health Policy


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