Medicaid Access to Naloxone: A Look at State Policies to Removing Barriers to Access

Medicaid, the health insurance program for low-income adults and children, plays a critical role in providing financial access to naloxone. All state Medicaid programs cover naloxone, and 38 programs place at least one formulation of it on their preferred drug list. 

Recent analyses of opioid education and naloxone distribution programs show that, on average, there is one overdose reversal -- a life saved -- for every 14.55 naloxone doses prescribed.[1]  Another recent study estimates the potential number of lives saved since the increase in Medicaid spending on naloxone and suggests that in 2016 there were nearly 7,000 reversals, compared with roughly 1,000 in 2013. [2]

[2]

A Preferred Drug List (PDL) is a list of outpatient drugs that states encourage providers to prescribe. NARCAN Nasal Spray is covered on 38 state Medicaid preferred drug lists:

• Alabama

• Alaska

• Arizona

• Arkansas

• California

• Colorado

• Connecticut

• Delaware

• Georgia

• Florida

• Hawaii

• Indiana

• Illinois

• Maine

• Maryland

• Massachusetts

• Michigan

• Minnesota

• Missouri

• Mississippi

• Montana

• North Carolina

• North Dakota

• New Hampshire

• New Jersey

• New York

• Ohio

• Oklahoma

• Oregon

• Pennsylvania

• South Carolina

• Tennessee

• Texas

• Washington

• Wisconsin

• Vermont

• Virginia

• Wyoming

NARCAN Nasal Spray coverage on 38 state Medicaid preferred drug lists:

For states not listed, it is becoming increasingly crucial to allow easy access to naloxone or other overdose reversal medications. NARCAN nasal spray is being shown to save lives and should be widely accessible in all parts of the United States. See below for more resources on the FDA announcement and information on how to add Narcan to your Preferred Drug List (PDL). 

• FDA Approves First Over-the-Counter Naloxone Nasal Spray 

• Medicaid Coverage of Medication-Assisted Treatment for Alcohol and Opioid Use Disorders and of Medication for the Reversal of Opioid Overdose

[1]  S. R. Mueller, A. Y. Walley, S. L. Calcaterra et al., “A Review of Opioid Overdose Prevention and Naloxone Prescribing: Implications for Translating Community Programming into Clinical Practice,” Substance Abuse, 2015 36(2):240–53.

[2] R. G. Frank and C. E. Fry, "Medicaid Expands Access to Lifesaving Naloxone," To the Point, The Commonwealth Fund, July 5, 2017. https://doi.org/10.26099/mjr1-2642