The University of Texas at Austin, College of Pharmacy, 2409 University Avenue, Austin, TX 78712, USA.
The University of Texas at Austin, College of Pharmacy, 2409 University Avenue, Austin, TX 78712, USA.
Drug Alcohol Depend. 2022 Aug 1;237:109518. doi: 10.1016/j.drugalcdep.2022.109518. Epub 2022 Jun 6.
Prompt access to prescribed buprenorphine/naloxone films (BUP/NX) and naloxone nasal spray (NNS) is vital for patients with opioid use disorder (OUD), but multiple studies have documented pharmacy-level barriers.
A cross-sectional secret shopper telephone audit was conducted in a sample of 5734 actively licensed pharmacies in 11 U.S. states from May 2020-April 2021. Primary outcomes included availability of 14 generic BUP/NX 8/2 mg and one unit of NNS 4 mg. Outcomes were compared by pharmacy type, county metropolitan status, state Medicaid expansion status, and state drug overdose death rate.
Data from 4984 pharmacies (3402 chain and 1582 independent) were analyzed. Both medications were available in 41.2 % of pharmacies, BUP/NX was available in 48.3%, and NNS was available in 69.5%. Chain pharmacies were significantly more likely than independent pharmacies to have both medications available, to have each medication available individually, and to be willing to order BUP/NX. Pharmacies in metropolitan counties were more likely to have BUP/NX available than pharmacies in non-metropolitan counties, pharmacies in Medicaid expansion states were more likely to have both medications available and to have NNS available than pharmacies in non-expansion states, and pharmacies in states with high drug overdose death rates were more likely to have NNS available than pharmacies in states with low drug overdose death rates.
BUP/NX and NNS are not readily accessible in many U.S. pharmacies. Deficits in access are most pronounced in independent pharmacies, though county- and state-level factors may also influence availability of these essential medications.
对于患有阿片类药物使用障碍（OUD）的患者来说，能够及时获得处方丁丙诺啡/纳洛酮膜（BUP/NX）和纳洛酮鼻喷剂（NNS）至关重要，但多项研究记录了药房层面的障碍。
2020 年 5 月至 2021 年 4 月，在美国 11 个州的 5734 家活跃持照药房中进行了一项横断面秘密购物者电话审计。主要结果包括 14 种通用 BUP/NX 8/2mg 和一种 4mg 的 NNS 的供应情况。根据药房类型、县市区状态、州医疗补助扩张状态和州药物过量死亡率比较结果。
对 4984 家药房（3402 家连锁和 1582 家独立）的数据进行了分析。两种药物在 41.2%的药房中都有供应，BUP/NX 的供应比例为 48.3%，NNS 的供应比例为 69.5%。连锁药房比独立药房更有可能同时提供这两种药物，更有可能单独提供每种药物，并且更愿意订购 BUP/NX。市区县的药房比非市区县的药房更有可能提供 BUP/NX，医疗补助扩张州的药房比非扩张州的药房更有可能同时提供这两种药物并提供 NNS，而药物过量死亡率较高的州的药房比药物过量死亡率较低的州的药房更有可能提供 NNS。
在美国许多药房中，BUP/NX 和 NNS 不易获得。在独立药房中，获取这些基本药物的缺口最为明显，但县和州一级的因素也可能影响这些药物的供应。
