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. 2024 Jul-Aug;64(4):102093.
doi: 10.1016/j.japh.2024.102093. Epub 2024 Apr 10.

The association between naloxone claims and proportion of independent versus chain pharmacies: A longitudinal analysis of naloxone claims in the United States

Christina E Freibott, Ali Jalali, Sean M Murphy, Alexander Y Walley, Benjamin P Linas, Philip J Jeng, Jeffrey Bratberg, Brandon D L Marshall, Xiao Zang, Traci C Green, Jake R Morgan

The association between naloxone claims and proportion of independent versus chain pharmacies: A longitudinal analysis of naloxone claims in the United States

Christina E Freibott et al. J Am Pharm Assoc (2003). 2024 Jul-Aug.

Abstract

Background: Expanding access to naloxone through pharmacies is an important policy goal. Our objective was to characterize national county-level naloxone dispensing of chain versus independent pharmacies.

Methods: The primary exposure in our longitudinal analysis was the proportion of chain pharmacies in a county, identified through the U.S. Department of Homeland Security 2010 Infrastructure Foundation-Level Data. We defined counties as having "higher proportion" of chain pharmacies if at least 50% of pharmacies were large national chains. The primary outcome was quarter-year (2016Q1-2019Q2) rate of pharmacy naloxone claims per 100,000 persons from Symphony Health at the county level. We compared the naloxone dispensing rate between county types using 2-sample t tests. We estimated the association between county-level chain pharmacy proportion and rate of naloxone claims using a linear model with year-quarter fixed effects.

Results: Nearly one-third of counties (n = 946) were higher proportion. Higher proportion counties had a significantly higher rate of naloxone claims across the study period, in 4 of 6 urban-rural classifications, and in counties with and without naloxone access laws (NALs). The linear model confirmed that higher proportion counties had a significantly higher rate of naloxone claims, adjusting for urban-rural designation, income, population characteristics, opioid mortality rate, coprescribing laws, and NALs.

Conclusion: In this national study, we found an association between naloxone dispensing rates and the county-level proportion of chain (vs. independent) pharmacies. Incentivizing naloxone dispensing through educational, regulatory, or legal efforts may improve naloxone availability and dispensing rates-particularly in counties with proportionately high numbers of independent pharmacies.

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Conflict of interest statement

Disclosure The authors declare no relevant conflicts of interest or financial relationships.

Figures

Figure 1.
Figure 1.
Rate of county-level naloxone claims from 2016 to 2019
See this image and copyright information in PMC

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