PDF(Pubmed)
Abstract：
BACKGROUND: Opioid overdoses in the USA have increased to unprecedented levels. Administration of the opioid antagonist naloxone can prevent overdoses.
OBJECTIVE: This study was conducted to reveal the pharmacoepidemiologic patterns in naloxone prescribing to Medicaid patients from 2018 to 2021 as well as Medicare in 2019.
METHODS: Observational pharmacoepidemiologic study SETTING: US Medicare and Medicaid naloxone claims INTERVENTION: The Medicaid State Drug Utilisation Data File was utilised to extract information on the number of prescriptions and the amount prescribed of naloxone at a national and state level. The Medicare Provider Utilisation and Payment was also utilised to analyse prescription data from 2019.
METHODS: States with naloxone prescription rates that were outliers of quartile analysis were noted.
RESULTS: The number of generic naloxone prescriptions per 100 000 Medicaid enrollees decreased by 5.3%, whereas brand naloxone prescriptions increased by 245.1% from 2018 to 2021. There was a 33.1-fold difference in prescriptions between the highest (New Mexico=1809.5) and lowest (South Dakota=54.6) states in 2019. Medicare saw a 30.4-fold difference in prescriptions between the highest (New Mexico) and lowest states (also South Dakota) after correcting per 100 000 enrollees.
CONCLUSIONS: This pronounced increase in the number of naloxone prescriptions to Medicaid patients from 2018 to 2021 indicates a national response to this widespread public health emergency. Further research into the origins of the pronounced state-level disparities is warranted.
OBJECTIVE: This study was conducted to reveal the pharmacoepidemiologic patterns in naloxone prescribing to Medicaid patients from 2018 to 2021 as well as Medicare in 2019.
METHODS: Observational pharmacoepidemiologic study SETTING: US Medicare and Medicaid naloxone claims INTERVENTION: The Medicaid State Drug Utilisation Data File was utilised to extract information on the number of prescriptions and the amount prescribed of naloxone at a national and state level. The Medicare Provider Utilisation and Payment was also utilised to analyse prescription data from 2019.
METHODS: States with naloxone prescription rates that were outliers of quartile analysis were noted.
RESULTS: The number of generic naloxone prescriptions per 100 000 Medicaid enrollees decreased by 5.3%, whereas brand naloxone prescriptions increased by 245.1% from 2018 to 2021. There was a 33.1-fold difference in prescriptions between the highest (New Mexico=1809.5) and lowest (South Dakota=54.6) states in 2019. Medicare saw a 30.4-fold difference in prescriptions between the highest (New Mexico) and lowest states (also South Dakota) after correcting per 100 000 enrollees.
CONCLUSIONS: This pronounced increase in the number of naloxone prescriptions to Medicaid patients from 2018 to 2021 indicates a national response to this widespread public health emergency. Further research into the origins of the pronounced state-level disparities is warranted.
摘要：
背景：在美国，阿片类药物过量已增加到前所未有的水平。阿片样物质拮抗剂纳洛酮的施用可以防止过量。
目的：这项研究旨在揭示2018年至2021年为Medicaid患者开具的纳洛酮处方以及2019年的Medicare的药物流行病学模式。
方法：观察性药物流行病学研究设置：美国医疗保险和医疗补助纳洛酮索赔干预：医疗补助国家药物利用数据文件用于提取有关处方数量和纳洛酮处方量的信息在国家和州一级。医疗保险提供者的使用和支付也被用来分析2019年的处方数据。
方法：注意到纳洛酮处方率是四分位数分析的异常值。
结果：每100,000名医疗补助参与者的通用纳洛酮处方数量减少了5.3％，而品牌纳洛酮处方从2018年到2021年增长了245.1%。2019年，最高州（新墨西哥州=1809.5）和最低州（南达科他州=54.6）之间的处方差异为33.1倍。在每10万名参与者进行校正后，医疗保险在最高的州（新墨西哥州）和最低的州（也是南达科他州）之间的处方差异为30.4倍。
结论：从2018年到2021年，医疗补助患者的纳洛酮处方数量明显增加，表明国家对这种广泛的公共卫生紧急情况做出了反应。有必要对明显的州级差异的起源进行进一步研究。
目的：这项研究旨在揭示2018年至2021年为Medicaid患者开具的纳洛酮处方以及2019年的Medicare的药物流行病学模式。
方法：观察性药物流行病学研究设置：美国医疗保险和医疗补助纳洛酮索赔干预：医疗补助国家药物利用数据文件用于提取有关处方数量和纳洛酮处方量的信息在国家和州一级。医疗保险提供者的使用和支付也被用来分析2019年的处方数据。
方法：注意到纳洛酮处方率是四分位数分析的异常值。
结果：每100,000名医疗补助参与者的通用纳洛酮处方数量减少了5.3％，而品牌纳洛酮处方从2018年到2021年增长了245.1%。2019年，最高州（新墨西哥州=1809.5）和最低州（南达科他州=54.6）之间的处方差异为33.1倍。在每10万名参与者进行校正后，医疗保险在最高的州（新墨西哥州）和最低的州（也是南达科他州）之间的处方差异为30.4倍。
结论：从2018年到2021年，医疗补助患者的纳洛酮处方数量明显增加，表明国家对这种广泛的公共卫生紧急情况做出了反应。有必要对明显的州级差异的起源进行进一步研究。
