Investigating the complexity of naloxone distribution: Which policies matter for pharmacies and potential recipients

IF 3.4 2区 经济学 Q1 ECONOMICS
Rosanna Smart , David Powell , Rosalie Liccardo Pacula , Evan Peet , Rahi Abouk , Corey S. Davis
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引用次数: 0

Abstract

Despite efforts to expand naloxone access, opioid-related overdoses remain a significant contributor to mortality. We study state efforts to expand naloxone distribution through pharmacies by reducing the non-monetary costs to prescribers, dispensers, and/or potential recipients of naloxone. We find that laws that only address liability costs have small and insignificant effects on the volume of naloxone dispensed through pharmacies. In contrast, we estimate large effects of laws removing the need for patients to obtain prescriptions from traditional prescribers (e.g., primary care physicians): laws authorizing non-patient-specific prescription distribution and laws granting pharmacists prescriptive authority. We test whether areas designated as primary care shortage areas—where it would be costlier to obtain a prescription—were disproportionately impacted. Shortage areas experienced sharper growth in pharmacy naloxone dispensing in states adopting prescriptive authority policies. These gains were primarily due to those facing low out-of-pocket costs, suggesting that price barriers also must be addressed to increase naloxone purchases.

调查纳洛酮分发的复杂性:哪些政策对药店和潜在接受者至关重要
尽管各州努力扩大纳洛酮的使用范围,但与阿片类药物相关的用药过量仍是导致死亡的重要原因。我们研究了各州通过降低处方者、配药者和/或纳洛酮潜在接受者的非货币成本来扩大纳洛酮通过药店配药的努力。我们发现,只涉及责任成本的法律对通过药店发放纳洛酮的数量影响很小,而且不显著。与此相反,我们估算出了免除患者从传统处方者(如初级保健医生)处获得处方的法律所产生的巨大影响:授权非特定患者处方分配的法律和授予药剂师处方权的法律。我们检验了被指定为初级保健短缺地区的地区(在这些地区获取处方的成本更高)是否受到了不成比例的影响。在采用处方权政策的州,短缺地区的纳洛酮药房配药量增长更快。这些增长主要归功于那些自付费用较低的地区,这表明要增加纳洛酮的购买量,还必须解决价格障碍。
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来源期刊
Journal of Health Economics
Journal of Health Economics 医学-卫生保健
CiteScore
6.10
自引率
2.90%
发文量
96
审稿时长
49 days
期刊介绍: This journal seeks articles related to the economics of health and medical care. Its scope will include the following topics: Production and supply of health services; Demand and utilization of health services; Financing of health services; Determinants of health, including investments in health and risky health behaviors; Economic consequences of ill-health; Behavioral models of demanders, suppliers and other health care agencies; Evaluation of policy interventions that yield economic insights; Efficiency and distributional aspects of health policy; and such other topics as the Editors may deem appropriate.
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