Barriers to Purchasing Narcan® in Georgia: A Survey of Pharmacy Staff

Abstract

, ABSTRACTBackground: In Georgia, recent measures have expanded public access to naloxone-containing products like Narcan® to combat opioid-related overdose deaths. Although laypersons may legally purchase naloxone products without a prescription for use during opioid-related overdose events, barriers may remain. Methods: We conducted an anonymous telephone survey to investigate three potential barriers to purchasing naloxone (Narcan®) in Georgia: availability, price, and working knowledge of legal requirements among pharmacy representatives. We surveyed pharmacy representatives in select Georgia counties with high volumes or high rates of poisoning deaths compared with other counties. We also compared responses among chain and non-chain representatives. Descriptive statistics are presented concerning the availability, price, and required documentation to purchase Narcan®. Results: Representatives from all 120 pharmacies contacted completed the survey, comprising 6.8% of eligible pharmacies. Availability of Narcan® varied among counties categorized by poisoning deaths: High Rate Counties (50%; n=40), High Volume Counties (66%; n=38), and Comparison Counties (64%, n=42). Narcan® was more available in chain pharmacies (76.7%; n=73) than in non-chain pharmacies (34.0%; n=47). Mean prices for Narcan® were similar among county type: High Volume ($131.46); High Rate ($134.19); and Comparison ($124.50). However, the mean price was much lower in chain versus non-chain pharmacies ($120.91 vs. $149.72). Representatives in chain pharmacies were more likely to state that a prescription was not required to purchase Narcan® (58.9 % vs. 30.0%). Conclusions: In Georgia, barriers related to availability, price, and dispensing requirements for Narcan® persist, decreasing the likelihood of purchase by those who may need a safe, easily administered form of naloxone. Narcan® was generally more available and cost less in chain pharmacies. Representatives in non-chain pharmacies were more likely to require a non-legally necessary prescription to sell Narcan®. Training/intervention opportunities targeting pharmacy staff may help increase layperson access to naloxone products and could ultimately prevent opioid-related overdose deaths.