Data Brief: Naloxone Prescription in Response to the Opioid Epidemic

In response to the opioid epidemic, policies to expand access to the overdose-reversal drug naloxone have emerged across the country. In Arkansas, Act 651 of 2021, which went into effect on July 28, 2021, requires a co-prescription of naloxone in certain situations, including when a dosage for an opioid prescription is 50 or more morphine milligram equivalents (MME) per day. In 2017, licensed pharmacists became authorized to dispense naloxone to individuals without a prescription under a state protocol.

Since 2020, ACHI has conducted annual analyses of naloxone and opioid prescriptions for Medicaid and commercially insured enrollees. Data for the analyses were from the Arkansas All-Payer Claims Database, part of the Arkansas Healthcare Transparency Initiative, for state fiscal years (FY) 2017 to 2022. The results of our analyses are contained in an updated data brief.

Key findings:

• From FY 2021 to FY 2022, there was a 366% increase in naloxone prescription fills and a 340% increase in enrollees who filled a naloxone prescription.
• The number of enrollees who filled opioid prescriptions decreased overall from FY 2017 to FY 2022, while the number of enrollees who filled naloxone prescriptions increased.
• The percentages of enrollees who filled both naloxone and high-dose opioid prescriptions increased from FY 2017 to FY 2022.
  • Among enrollees who filled opioid prescriptions of 50 or more MME per day, the rate of fills from naloxone co-prescribing increased from 0.06% in FY 2017 to 17.58% in FY 2022.
  • Among enrollees who filled opioid prescriptions of 90 or more MME per day, the rate of fills from naloxone co-prescribing increased from 0.12% in FY 2017 to 24.93% in FY 2022.

• The ratio of naloxone prescription fills to the number of enrollees receiving high-dose opioid prescriptions improved from FY 2021 to FY 2022.
  • In FY 2022, one naloxone prescription was filled for every six enrollees with opioid prescriptions of 50 or more MME per day, an improvement from one naloxone prescription fill per 19 enrollees in FY 2021.
  • In FY 2022, one naloxone prescription was filled for every four enrollees with opioid prescriptions of 90 or more MME per day, an improvement from one naloxone prescription fill per 11 enrollees in FY 2021.

• In FY 2022, 2,533 out of 25,987 naloxone prescription fills, or 9.7%, were done by pharmacists under a state protocol.