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Out-of-Pocket Cost of Naloxone Soars for Uninsured Individuals
While the cost of naloxone has declined for individuals with health insurance, the cost of the opioid overdose reversal medication has sharply risen for uninsured individuals in recent years, according to new data from RAND Corporation.
Findings from the study were published in the journal JAMA Health Forum.
From 2014 to 2018, the out-of-pocket cost for naloxone increased more than 500% per prescription for those without insurance. Meanwhile, those with insurance saw their out-of-pocket cost decline by 26%. About 20% of US adults with an opioid use disorder (OUD) are uninsured, and uninsured Americans account for nearly one-third of opioid overdose deaths.
Despite concentrated legislative efforts to improve access to naloxone by passing laws that ease requirements around prescribing and dispensing the medication, many states are falling short by failing to address financial barriers, study lead author Evan Peet, an economist at RAND, said in a news release.
“The price of naloxone is almost certainly an impediment to more-widespread adoption among the uninsured,” Peet said. “Policymakers who want to further expand access to naloxone—particularly among the uninsured and vulnerable—need to pay greater attention to the out-of-pocket costs.”
RAND researchers’ findings were based on an analysis of more than 700,000 prescription records from 2010 to 2018 for both generic and name-brand naloxone. More than 70% of US retail pharmacies were accounted for in the data. In 2014, the average per-prescription out-of-pocket cost for naloxone was $27 among insured individuals, compared to $35 for those who were uninsured. By 2018, the out-of-pocket cost for those without insurance soared to $250, compared to just $18 for those with health insurance.
During the period studied, the total number of naloxone prescriptions grew exponentially, with 386,249 prescriptions written in 2018, up from 11,432 in 2010.
The RAND researchers who conducted the study offered several potential avenues for financial relief. Among the solutions offered by RAND, the not-for-profit suggested that policymakers could consider implementing financial subsidies, regulating copays for insured individuals, and issuing coupons for those without insurance.
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