Division of Overdose Prevention, Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Pediatrics. 2024 Oct 1;154(4). doi: 10.1542/peds.2023-065137.
Naloxone is lifesaving in the event of an opioid overdose but is underutilized in adolescents. Youth-serving clinicians can play a role in expanding naloxone access by offering it to all youth at risk for opioid-involved overdose, including by prescription. Understanding naloxone dispensing trends to youth can inform efforts to expand its use.
We used IQVIA National Prescription Audit Patient Insights data, which contains prescriptions dispensed from ∽48 900 retail pharmacies, representing 93% of all prescriptions from all payers in the United States. Cross-sectional analyses were used to describe naloxone dispensing trends among youth ages 10 to 19 years over time and by patient sex, out-of-pocket cost, prescriber specialty, and payer.
From 2017 to 2022, 59 077 prescriptions for naloxone were dispensed to youth ages 10 to 19. Dispensing rates increased 669%, from 6.6 to 50.9 prescriptions per 100 000 adolescents, with increases each year. Dispensing varied by specialty and sex. Pediatricians accounted for an increasing proportion of prescriptions dispensed with a 6-year increase of 991%. Seventy-four percent of prescriptions were paid through commercial insurance. Although most prescriptions dispensed had low to 0 cost-sharing, 20% had out-of-pocket costs exceeding $25, and over 6% had out-of-pocket costs exceeding $75.
Pediatricians and other youth-serving clinicians can play an important role in expanding access to naloxone and harm reduction information by prescribing naloxone to all youth who are at risk for overdose. Clinician prescribing of naloxone can augment community distribution and over-the-counter access by making naloxone more widely available at all touchpoints with the health care system.
纳洛酮在阿片类药物过量的情况下可挽救生命，但在青少年中的使用率较低。为扩大纳洛酮的获取途径，为所有有阿片类药物过量风险的青少年提供纳洛酮，包括通过处方提供，青少年服务临床医生可以发挥作用。了解向青少年提供纳洛酮的趋势可以为扩大其使用提供信息。
我们使用了 IQVIA 全国处方审计患者洞察数据，该数据包含来自∽48900 家零售药店的处方，占美国所有支付者的所有处方的 93%。使用横截面分析来描述青少年 10 至 19 岁之间随时间和患者性别、自付费用、处方医生专业和支付者的纳洛酮配药趋势。
从 2017 年到 2022 年，向青少年 10 至 19 岁的人群开出了 59077 份纳洛酮处方。配药率增加了 669%，从每 10 万青少年 6.6 到 50.9 份，每年都在增加。配药因专业和性别而异。儿科医生开出的处方比例不断增加，6 年内增加了 991%。74%的处方通过商业保险支付。尽管大多数开出的处方自付费用低至 0，但有 20%的处方自付费用超过 25 美元，超过 6%的处方自付费用超过 75 美元。
儿科医生和其他青少年服务临床医生可以通过向所有有过量风险的青少年开具纳洛酮处方，在扩大纳洛酮和减少伤害信息的获取途径方面发挥重要作用。临床医生开具纳洛酮可以通过使纳洛酮在与医疗保健系统的所有接触点更广泛地可用，从而增加社区的分发和非处方获取。
