Medicaid prescription limits and their implications for naloxone accessibility.
Medicaid prescription limits and their implications for naloxone accessibility.
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DOI：
10.1016/j.drugalcdep.2020.108355
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发表时间：
2021-01-01
影响因子：
4.2
通讯作者：
Carpenter DM
中科院分区：
文献类型：
--
作者：
Roberts AW;Look KA;Trull G;Carpenter DM
20%的州医疗补助计划实行每月处方药配药限制政策。处方填充限制可能会对Medicaid覆盖的纳洛酮填充构成障碍。纳洛酮豁免可以改善纳洛酮的获得并防止阿片类药物过量死亡。扩大纳洛酮的获得和利用是预防阿片类药物过量死亡的一项至关重要的减少伤害战略，特别是在医疗补助受益人等弱势群体中。本研究的目的是描述医疗补助计划中每月处方填充限制政策的特点及其对扩大纳洛酮使用以减少阿片类药物过量危害的潜在影响。一个横截面，多模式的在线和电话数据收集策略被用来识别和描述跨州医疗补助计划的每月处方填写限制政策的存在和特点。描述了每个州的医疗补助登记，阿片类药物处方率和过量死亡率的背景特征。数据收集和分析于2020年2月至5月期间进行。医疗补助覆盖的纳洛酮填充目前受到10个州医疗补助计划的每月处方填充限制政策的约束，这些计划覆盖了全国20%的医疗补助人口。其中7个项目位于全国人均阿片类药物处方率排名前10位的州。然而，其中8个项目位于阿片类药物过量死亡率低于全国平均水平的州。生活在具有每月处方填充限制的州的阿片类药物过量高风险的医疗补助受益人可能会遇到获得纳洛酮的重大障碍。从医疗补助处方限制中免除纳洛酮可能有助于刺激纳洛酮更广泛地用于阿片类药物过量死亡预防，特别是在阿片类药物处方率高的州。在医疗补助中实现不受限制的纳洛酮覆盖至关重要，因为在COVID-19大流行期间阿片类药物过量和医疗补助入学率增加。
20 % of state Medicaid programs operate monthly prescription fill limit policies. Prescription fill limits may pose barriers to Medicaid-covered naloxone fills. Naloxone exemptions may improve naloxone access and prevent opioid overdose deaths. Expanding access to and utilization of naloxone is a vitally important harm reduction strategy for preventing opioid overdose deaths, particularly in vulnerable populations like Medicaid beneficiaries. The objective of this study was to characterize the landscape of monthly prescription fill limit policies in Medicaid programs and their potential implications for expanding naloxone use for opioid overdose harm reduction. A cross-sectional, multi-modal online and telephonic data collection strategy was used to identify and describe the presence and characteristics of monthly prescription fill limit policies across state Medicaid programs. Contextual characteristics were described regarding each state’s Medicaid enrollment, opioid prescribing rates, and overdose death rates. Data collection and analysis occurred between February and May 2020. Medicaid-covered naloxone fills are currently subject to monthly prescription fill limit policies in 10 state Medicaid programs, which cover 20 % of the Medicaid population nationwide. Seven of these programs are located in states ranking in the top 10 highest per-capita opioid prescribing rates in the country. However, 8 of these programs are located in states with opioid overdose death rates below the national average. Medicaid beneficiaries at high risk of opioid overdose living in states with monthly prescription fill limits may experience significant barriers to obtaining naloxone. Exempting naloxone from Medicaid prescription limit restrictions may help spur broader adoption of naloxone for opioid overdose mortality prevention, especially in states with high opioid prescribing rates. Achieving unfettered naloxone coverage in Medicaid is critical as opioid overdoses and Medicaid enrollment increase amid the COVID-19 pandemic.
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药物和阿片类药物涉及过量死亡 - 美国，2017-2018。
DOI：
10.15585/mmwr.mm6911a4
发表时间：
2020-03-20
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Wilson N;Kariisa M;Seth P;Smith H 4th;Davis NL
通讯作者：
Davis NL
影响因子：
4.2
作者：
Slavova, Svetla;Rock, Peter;Walsh, Sharon L.
通讯作者：
Walsh, Sharon L.
影响因子：
5.1
作者：
Han, Benjamin H.;Sherman, Scott E.;Palamar, Joseph J.
通讯作者：
Palamar, Joseph J.
影响因子：
2.5
作者：
Feng, Xue;Tan, Xi;Sambamoorthi, Usha
通讯作者：
Sambamoorthi, Usha
DOI：
10.1016/j.sapharm.2018.04.002
发表时间：
2019-03
期刊：
Research in social & administrative pharmacy : RSAP
影响因子：
--
作者：
Roberts AW;Carpenter DM;Smith A;Look KA
通讯作者：
Look KA