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Utilization and Pricing Trends for Naloxone in Medicaid

Opioid abuse and overdose deaths are at epidemic levels in the United States. In response, both the U.S. Surgeon General and CMS have stated that increasing access to naloxone, especially among members of the public who are at risk or who know someone at risk, is a top priority. Naloxone is a medication designed to rapidly reverse opioid overdose. However, many stakeholders have expressed concerns that the high cost of naloxone may impede increased access. Medicaid could play a significant role in addressing the issue of naloxone access because the program covers nearly 40 percent of nonelderly adults with opioid addiction. This report will show (1) trend utilization of and expenditures for naloxone in Medicaid over a 5-year period; (2) determine how the cost-per-dose for naloxone under Medicaid compares to other available prices; and (3) determine the proportion of all naloxone distributed in the U.S. that was paid under Medicaid between 2014 and 2018. This information can help stakeholders determine how to cost-effectively increase naloxone access to affected Medicaid-eligible beneficiaries.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Completed Centers for Medicare & Medicaid Services Utilization and Pricing Trends for Naloxone in Medicaid Office of Evaluation and Inspections OEI-BL-18-00360 2021