Abstract
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 language | English |
---|---|
Pages (from-to) | 239-248 |
Number of pages | 10 |
Journal | Health Services Research |
Volume | 55 |
Issue number | 2 |
DOIs | |
State | Published - Apr 1 2020 |
Bibliographical note
Publisher Copyright:© Health Research and Educational Trust
Funding
We would like to thank Heather Bush and Svetla Slavova for providing statistical advice and Jungjun Bae for assisting with statistical analysis. This research was funded, in part, by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001998 and the National Institute on Drug Abuse of the National Institutes of Health under award number T32 DA016176. Dr Lofwall reported receiving consulting fees from Titan Pharmaceuticals, Inc outside the submitted work. Joint Acknowledgment/Disclosure Statement:
Funders | Funder number |
---|---|
National Institutes of Health (NIH) | |
National Institute on Drug Abuse | T32 DA016176 |
National Institute on Drug Abuse | |
National Center for Advancing Translational Sciences (NCATS) | UL1TR001998 |
National Center for Advancing Translational Sciences (NCATS) |
Keywords
- Medicaid
- Patient Protection and Affordable Care Act
- drug overdose
- naloxone
- opioid epidemic
ASJC Scopus subject areas
- Health Policy