PDF(Pubmed)
Abstract：
UNASSIGNED: The US Food and Drug Administration approved Narcan, a nasal spray formulation of naloxone, for sale as an over-the-counter (OTC) medication in March 2023. The purpose of OTC approval was to improve naloxone accessibility to reduce opioid overdoses; however, research has not yet evaluated whether naloxone\'s availability and cost changed since this policy was implemented.
UNASSIGNED: To evaluate whether the accessibility and cost of naloxone at North Carolina community pharmacies changed after OTC naloxone became available and whether cost and availability varied by pharmacy type and urbanicity.
UNASSIGNED: This longitudinal telephone-based secret shopper survey study included a stratified sample of 202 North Carolina community pharmacies, including health department, independent, and chain pharmacies. There were 2 separate data collection efforts from March to April 2023 (before OTC naloxone could be sold at pharmacies) and November 2023 to January 2024 (after OTC naloxone was sold at pharmacies).
UNASSIGNED: OTC naloxone first became available for sale at community pharmacies in September 2023.
UNASSIGNED: The main outcomes were same-day availability of naloxone without a clinician-issued prescription and the quoted out-of-pocket cost for cash-paying patients.
UNASSIGNED: Data were collected from 192 pharmacies. Same-day naloxone availability increased from 42.2% (81 of 192) before OTC naloxone availability to 57.8% (111 of 192) after (P < .001). The mean (SD) quoted out-of-pocket cost decreased from $90.93 ($42.6) pre-OTC availability to $62.67 ($41.0) post-OTC availability (P < .001). Independent pharmacies had higher mean (SD) costs than chain pharmacies in both the pre-OTC phase ($109.47 [$37.90] vs $86.40 [$35.70]; P < .001) and post-OTC phase ($77.59 [$38.90] vs $57.74 [$35.90]; P = .004). Out-of-pocket costs did not differ by urbanicity in the pre-OTC phase; however, mean (SD) costs were higher at suburban ($88.67 [$66.80]) and rural ($65.43 [$35.00]) pharmacies compared with urban pharmacies ($53.58 [$29.00]) in the post-OTC phase (P = .003).
UNASSIGNED: The Food and Drug Administration\'s approval of OTC naloxone nasal spray contributed to an increase in pharmacy-based availability of naloxone and a reduction of its cost for cash-paying patients. Cost was higher at independent pharmacies compared with chain pharmacies and lower in urban pharmacies compared with suburban and rural pharmacies.
UNASSIGNED: To evaluate whether the accessibility and cost of naloxone at North Carolina community pharmacies changed after OTC naloxone became available and whether cost and availability varied by pharmacy type and urbanicity.
UNASSIGNED: This longitudinal telephone-based secret shopper survey study included a stratified sample of 202 North Carolina community pharmacies, including health department, independent, and chain pharmacies. There were 2 separate data collection efforts from March to April 2023 (before OTC naloxone could be sold at pharmacies) and November 2023 to January 2024 (after OTC naloxone was sold at pharmacies).
UNASSIGNED: OTC naloxone first became available for sale at community pharmacies in September 2023.
UNASSIGNED: The main outcomes were same-day availability of naloxone without a clinician-issued prescription and the quoted out-of-pocket cost for cash-paying patients.
UNASSIGNED: Data were collected from 192 pharmacies. Same-day naloxone availability increased from 42.2% (81 of 192) before OTC naloxone availability to 57.8% (111 of 192) after (P < .001). The mean (SD) quoted out-of-pocket cost decreased from $90.93 ($42.6) pre-OTC availability to $62.67 ($41.0) post-OTC availability (P < .001). Independent pharmacies had higher mean (SD) costs than chain pharmacies in both the pre-OTC phase ($109.47 [$37.90] vs $86.40 [$35.70]; P < .001) and post-OTC phase ($77.59 [$38.90] vs $57.74 [$35.90]; P = .004). Out-of-pocket costs did not differ by urbanicity in the pre-OTC phase; however, mean (SD) costs were higher at suburban ($88.67 [$66.80]) and rural ($65.43 [$35.00]) pharmacies compared with urban pharmacies ($53.58 [$29.00]) in the post-OTC phase (P = .003).
UNASSIGNED: The Food and Drug Administration\'s approval of OTC naloxone nasal spray contributed to an increase in pharmacy-based availability of naloxone and a reduction of its cost for cash-paying patients. Cost was higher at independent pharmacies compared with chain pharmacies and lower in urban pharmacies compared with suburban and rural pharmacies.
摘要：
■美国食品和药物管理局批准了Narcan，纳洛酮的喷鼻剂,2023年3月作为非处方药(OTC)出售。OTC批准的目的是改善纳洛酮的可及性，以减少阿片类药物过量；然而，研究还没有评估纳洛酮的可用性和成本是否改变自该政策实施以来。
■评估在OTC纳洛酮上市后，北卡罗来纳州社区药房纳洛酮的可及性和成本是否发生变化，以及成本和可获得性是否因药房类型和城市化而异。
■这项基于纵向电话的秘密购物者调查研究包括对北卡罗来纳州202家社区药房的分层抽样，包括卫生部门,独立,连锁药店。从2023年3月至4月（在药房出售OTC纳洛酮之前）和2023年11月至2024年1月（在药房出售OTC纳洛酮之后）进行了两次单独的数据收集工作。
■非处方纳洛酮于2023年9月首次在社区药房出售。
主要结果是在没有临床医生开具处方的情况下，当天可使用纳洛酮，以及现金支付患者的自付费用。
■数据来自192家药房。当天的纳洛酮可用性从OTC纳洛酮可用性前的42.2%（192个中的81个）增加到之后的57.8%（192个中的111个）（P<.001）。平均（SD）报价自付成本从场外交易前的90.93美元（42.6美元）降至场外交易后的62.67美元（41.0美元）（P<.001）。在OTC前阶段（$109.47[$37.90]vs$86.40[$35.70];P<.001）和OTC后阶段（$77.59[$38.90]vs$57.74[$35.90];P=.004），独立药房的平均（SD）成本均高于连锁药房。在OTC前阶段，自付费用没有因城市化而不同；然而，在OTC后阶段,与城市药房(53.58美元[29.00美元])相比,郊区药房(88.67美元[66.80美元])和农村药房(65.43美元[35.00美元])的平均(SD)费用较高(P=.003).
■美国食品和药物管理局批准非处方纳洛酮鼻喷雾剂有助于增加基于药房的纳洛酮供应，并降低现金支付患者的成本。与连锁药店相比，独立药店的成本更高，而与郊区和农村药店相比，城市药店的成本更低。
■评估在OTC纳洛酮上市后，北卡罗来纳州社区药房纳洛酮的可及性和成本是否发生变化，以及成本和可获得性是否因药房类型和城市化而异。
■这项基于纵向电话的秘密购物者调查研究包括对北卡罗来纳州202家社区药房的分层抽样，包括卫生部门,独立,连锁药店。从2023年3月至4月（在药房出售OTC纳洛酮之前）和2023年11月至2024年1月（在药房出售OTC纳洛酮之后）进行了两次单独的数据收集工作。
■非处方纳洛酮于2023年9月首次在社区药房出售。
主要结果是在没有临床医生开具处方的情况下，当天可使用纳洛酮，以及现金支付患者的自付费用。
■数据来自192家药房。当天的纳洛酮可用性从OTC纳洛酮可用性前的42.2%（192个中的81个）增加到之后的57.8%（192个中的111个）（P<.001）。平均（SD）报价自付成本从场外交易前的90.93美元（42.6美元）降至场外交易后的62.67美元（41.0美元）（P<.001）。在OTC前阶段（$109.47[$37.90]vs$86.40[$35.70];P<.001）和OTC后阶段（$77.59[$38.90]vs$57.74[$35.90];P=.004），独立药房的平均（SD）成本均高于连锁药房。在OTC前阶段，自付费用没有因城市化而不同；然而，在OTC后阶段,与城市药房(53.58美元[29.00美元])相比,郊区药房(88.67美元[66.80美元])和农村药房(65.43美元[35.00美元])的平均(SD)费用较高(P=.003).
■美国食品和药物管理局批准非处方纳洛酮鼻喷雾剂有助于增加基于药房的纳洛酮供应，并降低现金支付患者的成本。与连锁药店相比，独立药店的成本更高，而与郊区和农村药店相比，城市药店的成本更低。
